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Individual

MS. C YVONNE MICHELI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSWC MSW

Contact information

Practice address
65 DUKE ST, KAINE BLDG SUITE 111, PRINCE FREDERICK, MD 20678-6128
(410) 257-5750
(410) 257-5750
Mailing address
PO BOX 3568, 65 DUKE ST, #111, PRINCE FREDERICK, MD 20678-2578
(410) 257-5750
(410) 257-5750

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
02826
MD
106H00000X
Marriage & Family Therapist
02826
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3242370
TRICARE
01
3711-0001
CARE FIRST BLUE CROSS
MD
01
5562091
AETNA
01
QD82
BLUE CROSS
Enumeration date
09/07/2006
Last updated
12/18/2011
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