Healthcare Provider Details

I. General information

NPI: 1740632447
Provider Name (Legal Business Name): MICHELLE WARING MS, QBHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE DAWES

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 06/05/2023
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15930 19 MILE RD SUITE 150
CLINTON TWP MI
48038-1155
US

IV. Provider business mailing address

2960 CULBERTSON AVE
ROCHESTER HILLS MI
48307-4618
US

V. Phone/Fax

Practice location:
  • Phone: 586-464-0175
  • Fax:
Mailing address:
  • Phone: 248-318-2557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: