Provider Demographics
NPI:1427798925
Name:MICHAELS, MICHELLE JEANETTE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JEANETTE
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 SOMERSET PL
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-5437
Mailing Address - Country:US
Mailing Address - Phone:571-309-5824
Mailing Address - Fax:
Practice Address - Street 1:3907 SOMERSET PL
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-5437
Practice Address - Country:US
Practice Address - Phone:205-614-3516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2238103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist