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General NPI Number Information
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NPI Number | 1053192468
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Entity Type | Individual
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Provider Name | MICHELLE RICH LPA
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Gender | Female
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 201 W ASH ST STE 2
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City | GOLDSBORO
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State | NC
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Zip | 27530-3665
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Country | US
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Telephone | 919-330-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 44 BORDEAUX DR
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City | CLAYTON
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State | NC
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Zip | 27527-3399
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Country | US
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Telephone | 919-885-6515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5523
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License Number State | NC
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