Individual
MRS. GRETCHEN ELISA MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.T.
Contact information
Practice address
8131 RITCHIE HWY, SUITE E, PASADENA, MD 21122-6940
(410) 590-4360
(410) 590-4365
Mailing address
8004 ALEXIS CT, GLEN BURNIE, MD 21061-6175
(410) 553-0950
(410) 590-4365
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16879
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215719
KAISER PERMANENTE
MD
01
—
2437714
AETNA
MD
01
—
47610070
CAREFIRST RENDERING #
DC
01
—
529392-04
BCBS OF MD RENDERING #
MD
Enumeration date
08/01/2006
Last updated
11/13/2007
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