MEDICARE: MATIAH MCMICHAEL

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	225600000X	Dance Therapist

General Provider Information

NPI Number	:	1861358111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATIAH MCMICHAEL

Provider Business Mailing Address
First Line	:	8808 MCCRACKEN BLVD
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2302
Country	:	US
Telephone Number	:	216-801-3783
Fax Number	:

Provider Business Practice Location Address
First Line	:	8808 MCCRACKEN BLVD
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2302
Country	:	US
Telephone Number	:	216-801-3783
Fax Number	:

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

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

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Directions to “ MATIAH MCMICHAEL ” Practice Location

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