Provider Demographics
NPI:1316283138
Name:BOKMAN, MICHELLE (MS SPED)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BOKMAN
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 BATCHELDER ST
Mailing Address - Street 2:APT2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1414
Mailing Address - Country:US
Mailing Address - Phone:646-284-3153
Mailing Address - Fax:
Practice Address - Street 1:2533 BATCHELDER ST
Practice Address - Street 2:APT2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1414
Practice Address - Country:US
Practice Address - Phone:646-284-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist