Provider Demographics
NPI:1912239088
Name:DELLINGER, MICHELLE L (MS OTR)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:HOMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR
Mailing Address - Street 1:3126 S HART STREET RD
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591
Mailing Address - Country:US
Mailing Address - Phone:812-895-0799
Mailing Address - Fax:
Practice Address - Street 1:3126 S HART STREET RD
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591
Practice Address - Country:US
Practice Address - Phone:812-895-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002693A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist