Provider Demographics
NPI:1902674922
Name:EHRLER, MICHELLE AUDREY
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:AUDREY
Last Name:EHRLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HAZELHURST AVE
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-1604
Mailing Address - Country:US
Mailing Address - Phone:860-417-9514
Mailing Address - Fax:
Practice Address - Street 1:17 HAZELHURST AVE
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:CT
Practice Address - Zip Code:06779-1604
Practice Address - Country:US
Practice Address - Phone:860-417-9514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT130851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical