Healthcare Provider Details

I. General information

NPI: 1518647866
Provider Name (Legal Business Name): MICHELLE M OCASIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 SPRING ST
STRUTHERS OH
44471-1745
US

IV. Provider business mailing address

97 SPRING ST
STRUTHERS OH
44471-1745
US

V. Phone/Fax

Practice location:
  • Phone: 440-222-2593
  • Fax:
Mailing address:
  • Phone: 440-222-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: