Provider Demographics
NPI:1962116129
Name:CAMUS, MICHELE L
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:CAMUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 NW 43RD CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4728
Mailing Address - Country:US
Mailing Address - Phone:305-773-4006
Mailing Address - Fax:
Practice Address - Street 1:180 NW 43RD CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-4728
Practice Address - Country:US
Practice Address - Phone:305-773-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty