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NPI Code Detail

MEDICARE: MICHELLE LEIGH SOOY

MEDICARE: MICHELLE LEIGH SOOY
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1780516542
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LEIGH SOOY
Provider Business Mailing Address
First Line : 99 CRACKER BARREL DR STE 100
Second Line :
City : BARBOURSVILLE
State : WV
Zip : 25504-1650
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 511 MORRIS ST
Second Line :
City : CHARLESTON
State : WV
Zip : 25301-1326
Country : US
Telephone Number : 304-525-7851
Fax Number : 304-525-1073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ MICHELLE LEIGH SOOY ” Practice Location

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