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General NPI Number Information
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NPI Number | 1184409930
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Entity Type | Individual
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Provider Name | MICHELLE WIRSING
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Gender | Female
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1001 PAT BOOKER RD STE 200
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City | UNIVERSAL CITY
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State | TX
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Zip | 78148-4148
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Country | US
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Telephone | 830-285-5248
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Fax |
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Provider Business Mailing Address
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Address Line | 649 STEELE SHALLOWS
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City | CIBOLO
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State | TX
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Zip | 78108-0255
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Country | US
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Telephone | 989-714-7369
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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