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General NPI Number Information
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NPI Number | 1851150817
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Entity Type | Individual
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Provider Name | MICHELLE WITT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 101 DOUGLAS AVE
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City | MARTINSBURG
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State | WV
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Zip | 25404-4830
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Country | US
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Telephone | 681-389-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 101 DOUGLAS AVE
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City | MARTINSBURG
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State | WV
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Zip | 25404-4830
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Country | US
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Telephone | 681-389-2468
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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 | 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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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