Provider Demographics
NPI:1366769473
Name:CELLA, MICHELE E (MS)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:E
Last Name:CELLA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11254 HERITAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7405
Mailing Address - Country:US
Mailing Address - Phone:407-733-6771
Mailing Address - Fax:
Practice Address - Street 1:1000 DOUGLAS AVE
Practice Address - Street 2:APT 138
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2088
Practice Address - Country:US
Practice Address - Phone:407-733-6771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11629101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health