MEDICARE: MS. MICHELE LAURINE BACHMAN LPC

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	101YP2500X	Professional Counselor	70242	TX

General Provider Information

NPI Number	:	1477934305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE LAURINE BACHMAN LPC

Provider Business Mailing Address
First Line	:	2102 VERDE VALLEY DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-6495
Country	:	US
Telephone Number	:	832-819-1492
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3325
Country	:	US
Telephone Number	:	832-819-1492
Fax Number	:

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

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	06/16/2015

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