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NPI Code Detail

MEDICARE: MRS. MICHELLE JEANNE DUMBACHER OTR/L

MEDICARE: MRS. MICHELLE JEANNE DUMBACHER OTR/L
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
1225XN1300XNeurorehabilitation Occupational Therapist115808TX

General Provider Information

NPI Number : 1548521057
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE JEANNE DUMBACHER OTR/L
Provider Business Mailing Address
First Line : 409 W COMANCHE AVE
Second Line :
City : SHABBONA
State : IL
Zip : 60550-9790
Country : US
Telephone Number : 815-824-2194
Fax Number :
Provider Business Practice Location Address
First Line : 2000 MEDICAL DR
Second Line :
City : LAKEWAY
State : TX
Zip : 78734-4200
Country : US
Telephone Number : 512-263-4500
Fax Number : 512-263-4500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2012
Last Update Date : 04/30/2020

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