Healthcare Provider Details

I. General information

NPI: 1225959703
Provider Name (Legal Business Name): MICHELLE BARRY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SUDBROOK LN STE A
PIKESVILLE MD
21208-4184
US

IV. Provider business mailing address

5915 WYNDAM LN
BRIGHTON MI
48116-4745
US

V. Phone/Fax

Practice location:
  • Phone: 443-918-5575
  • Fax:
Mailing address:
  • Phone: 517-618-1357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSP0000000767643
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: