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General NPI Number Information
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NPI Number | 1700178431
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Entity Type | Individual
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Provider Name | MICHELLE MARIE WINEMILLER MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 1160 LAPORTE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80521-2422
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Country | US
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Telephone | 507-244-0222
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Fax | 970-821-8466
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Provider Business Mailing Address
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Address Line | 1160 LAPORTE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80521-2422
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Country | US
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Telephone | 507-269-9391
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2558
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License Number State | MN
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