MEDICARE: MICHELLE SMELLER MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	203690	TX

General Provider Information

NPI Number	:	1245862556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE SMELLER MFT

Provider Business Mailing Address
First Line	:	7928 SKYLAKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3041
Country	:	US
Telephone Number	:	817-881-7522
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 MERRETT DR STE C
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76135-2920
Country	:	US
Telephone Number	:	817-881-7522
Fax Number	:	817-754-5769

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2020
Last Update Date	:	12/17/2024

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Directions to “ MICHELLE SMELLER MFT” Practice Location

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