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General NPI Number Information
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NPI Number | 1538998703
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Entity Type | Individual
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Provider Name | MICHELLE SICA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1901 N DUPONT HWY
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City | NEW CASTLE
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State | DE
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Zip | 19720-1100
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Country | US
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Telephone | 302-255-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 139 WESLEY ST
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City | ELKTON
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State | MD
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Zip | 21921-5456
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Country | US
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Telephone | 443-790-4173
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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 | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number | U1-0012479
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License Number State | DE
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