Healthcare Provider Details

I. General information

NPI: 1285710343
Provider Name (Legal Business Name): MICHELLE L BEGAY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FORT DEFIANCE INDIAN HOSPITAL CORNER OF RT N12 & N7
FT. DEFIANCE AZ
86504
US

IV. Provider business mailing address

PO BOX 2097
CROWNPOINT NM
87313-2097
US

V. Phone/Fax

Practice location:
  • Phone: 928-729-8525
  • Fax: 928-729-8530
Mailing address:
  • Phone: 928-729-8525
  • Fax: 928-729-8530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-4342
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: