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General NPI Number Information
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NPI Number | 1558286237
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Entity Type | Individual
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Provider Name | MARIA MICHELLE AVERS
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Gender | Female
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 6215 FERRIS SQ
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City | SAN DIEGO
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State | CA
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Zip | 92121-3283
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Country | US
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Telephone | 800-683-1209
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Fax |
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Provider Business Mailing Address
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Address Line | 419 GRANDVIEW BLVD
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City | MUSKOGEE
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State | OK
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Zip | 74403-8614
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Country | US
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Telephone | 918-360-4756
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2058
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License Number State | OK
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