MEDICARE: MICHELLE FORLINE

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	103K00000X	Behavior Analyst	1-26-88538	TX

General Provider Information

NPI Number	:	1952075947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE FORLINE

Provider Business Mailing Address
First Line	:	6608 GULF FWY
Second Line	:
City	:	LA MARQUE
State	:	TX
Zip	:	77568-3099
Country	:	US
Telephone Number	:	134-669-2860
Fax Number	:

Provider Business Practice Location Address
First Line	:	6608 GULF FWY STE 112
Second Line	:
City	:	LA MARQUE
State	:	TX
Zip	:	77568-4095
Country	:	US
Telephone Number	:	134-669-2860
Fax Number	:

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

Provider Enumeration Date	:	08/04/2021
Last Update Date	:	04/16/2026

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Directions to “ MICHELLE FORLINE ” Practice Location

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