Provider Demographics
NPI:1831368885
Name:WONDERS, MICHELLE LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LOUISE
Last Name:WONDERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LOUISE
Other - Last Name:HERRIGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18445-0427
Mailing Address - Country:US
Mailing Address - Phone:484-942-9190
Mailing Address - Fax:570-252-4058
Practice Address - Street 1:RT. 390
Practice Address - Street 2:
Practice Address - City:MOUNTAINHOME
Practice Address - State:PA
Practice Address - Zip Code:18326
Practice Address - Country:US
Practice Address - Phone:484-942-9190
Practice Address - Fax:570-252-4058
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016717103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical