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General NPI Number Information
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NPI Number | 1992244941
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Entity Type | Individual
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Provider Name | MICHELLE SENTINELLA PTA
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Gender | Female
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 3400 NM 528 NW STE 106A
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-7025
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Country | US
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Telephone | 505-800-7810
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Fax |
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Provider Business Mailing Address
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Address Line | 187 SOUTHWOOD RD
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City | PASADENA
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State | MD
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Zip | 21122-4528
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Country | US
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Telephone | 443-742-1052
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA4740
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License Number State | MD
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