Provider Demographics
NPI:1982379889
Name:DOSTER, MICHELLE PHILLIPS
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PHILLIPS
Last Name:DOSTER
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 1:150 UPTOWN SQ STE C
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0581
Mailing Address - Country:US
Mailing Address - Phone:615-713-6221
Mailing Address - Fax:
Practice Address - Street 1:150 UPTOWN SQ
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0580
Practice Address - Country:US
Practice Address - Phone:615-713-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities