MEDICARE: MICHELLE FELDER

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	167G00000X	Licensed Psychiatric Technician	37294	CA

General Provider Information

NPI Number	:	1316836729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE FELDER

Provider Business Mailing Address
First Line	:	2141 S MISSION ST # 1026
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-4426
Country	:	US
Telephone Number	:	213-628-4705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2141 S MISSION ST # 1026
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-4426
Country	:	US
Telephone Number	:	213-628-4705
Fax Number	:

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

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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Directions to “ MICHELLE FELDER ” Practice Location

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