MEDICARE: MICHELE LYNN PAPPAS

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	225X00000X	Occupational Therapist	6422	SC

General Provider Information

NPI Number	:	1902548134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE LYNN PAPPAS

Provider Business Mailing Address
First Line	:	1281 PAINT HORSE CT
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29429-4972
Country	:	US
Telephone Number	:	201-965-6016
Fax Number	:

Provider Business Practice Location Address
First Line	:	1281 PAINT HORSE CT
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29429-4972
Country	:	US
Telephone Number	:	201-965-6016
Fax Number	:

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

Provider Enumeration Date	:	04/08/2022
Last Update Date	:	04/08/2022

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