Healthcare Provider Details

I. General information

NPI: 1750293379
Provider Name (Legal Business Name): MICHELLE LAWLESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 PINEHILL DR
MOBILE AL
36606-1735
US

IV. Provider business mailing address

165 S MONTEREY ST APT 7
MOBILE AL
36604-1274
US

V. Phone/Fax

Practice location:
  • Phone: 251-518-0512
  • Fax:
Mailing address:
  • Phone: 251-518-0512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2792
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: