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General NPI Number Information
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NPI Number | 1770842312
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Entity Type | Individual
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Provider Name | JULIE MICHELSON PCC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 41641 N RIDGE RD
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City | ELYRIA
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State | OH
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Zip | 44035-1245
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Country | US
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Telephone | 216-401-2568
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Fax |
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Provider Business Mailing Address
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Address Line | 28030 LINCOLN RD
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City | BAY VILLAGE
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State | OH
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Zip | 44140-2107
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Country | US
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Telephone | 440-413-6337
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.0006205
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License Number State | OH
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