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General NPI Number Information
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NPI Number | 1245995828
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Entity Type | Individual
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Provider Name | MICHELLE ANLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 11508 BARGELLO WAY
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City | PORTER RANCH
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State | CA
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Zip | 91326
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Country | US
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Telephone | 818-294-0576
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Fax |
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Provider Business Mailing Address
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Address Line | 7657 WINNETKA AVE # 414
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City | WINNETKA
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State | CA
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Zip | 91306-2677
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Country | US
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Telephone | 818-294-0576
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW70034
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License Number State | CA
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