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NPI Code Detail

MEDICARE: MICHELE STRAGE PH.D

MEDICARE: MICHELE STRAGE PH.D
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
1103T00000XPsychologist0810008432VA

General Provider Information

NPI Number : 1184497174
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE STRAGE PH.D
Provider Business Mailing Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 203-644-7072
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2023
Last Update Date : 04/09/2026

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