Provider Demographics
NPI:1104321363
Name:LINDERBORN, MICHELE L (RMP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:LINDERBORN
Suffix:
Gender:F
Credentials:RMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8193 BRANDON DR
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1340
Mailing Address - Country:US
Mailing Address - Phone:410-978-7035
Mailing Address - Fax:
Practice Address - Street 1:517 BENFIELD RD STE 101C
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2529
Practice Address - Country:US
Practice Address - Phone:443-906-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR01484225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist