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General NPI Number Information
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NPI Number | 1558033845
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Entity Type | Individual
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Provider Name | MICHELLE PANSY ADEMA
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Gender | Female
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 110 OASIS WAY UNIT 44
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City | LYNCHBURG
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State | VA
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Zip | 24502-1169
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Country | US
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Telephone | 618-899-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 E COLORADO BLVD STE 560
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City | PASADENA
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State | CA
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Zip | 91106-2380
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Country | US
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Telephone | 818-241-6780
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Fax | 818-241-6853
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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