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Individual

MS. KENDRA LEONA MICHEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
65 HERRINGTON DR, UPPER MARLBORO, MD 20774-1545
(301) 808-4060
Mailing address
14201 SCHOOL LN, UPPER MARLBORO, MD 20772-2866
(301) 952-6000

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
225X00000X
Occupational Therapist
025382
NY
225X00000X
Occupational Therapist
Primary
09776
MD
225X00000X
Occupational Therapist
122616
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
969633146
UNITED HEALTHCARE
NY
Enumeration date
10/06/2015
Last updated
03/29/2023
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