Provider Demographics
NPI:1801229190
Name:MUFF, MICHELLE (MA LAMFT)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:MUFF
Suffix:
Gender:F
Credentials:MA LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 STATE ST S
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093-3032
Mailing Address - Country:US
Mailing Address - Phone:507-310-1321
Mailing Address - Fax:
Practice Address - Street 1:505 STATE ST S
Practice Address - Street 2:SUITE 4
Practice Address - City:WASECA
Practice Address - State:MN
Practice Address - Zip Code:56093-3032
Practice Address - Country:US
Practice Address - Phone:507-310-1321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2207106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist