MEDICARE: MS. MICHELLE NICOLE GEIRINGER-LADER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1144559832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE NICOLE GEIRINGER-LADER

Provider Business Mailing Address
First Line	:	4409 AGUALINDA BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-6211
Country	:	US
Telephone Number	:	239-287-3989
Fax Number	:

Provider Business Practice Location Address
First Line	:	4409 AGUALINDA BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-6211
Country	:	US
Telephone Number	:	239-287-3989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2009
Last Update Date	:	12/09/2009

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