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NPI Code Detail

MEDICARE: MICHELLE MARIE GERBOZY LCSW

MEDICARE:   MICHELLE MARIE GERBOZY  LCSW
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
11041C0700XClinical Social Worker59818TX

General Provider Information

NPI Number : 1386184737
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MARIE GERBOZY LCSW
Provider Business Mailing Address
First Line : 1012 HIGHKNOLL LN
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-3203
Country : US
Telephone Number : 808-366-5414
Fax Number :
Provider Business Practice Location Address
First Line : 3008 DAWN DR STE 101
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-2822
Country : US
Telephone Number : 512-763-2751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2017
Last Update Date : 07/21/2022

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Directions to “ MICHELLE MARIE GERBOZY LCSW” Practice Location

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