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Individual

MICHELE DEFLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR, CHT

Contact information

Practice address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9882
Mailing address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9882

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
106952
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1021100149
HAND THERAPY CERTIFICATE
TX
01
1256670001
CIGNA DME PROVIDER
TX
01
752570786
FEIN
TX
01
8T6760
BCBS TX
Enumeration date
07/04/2006
Last updated
02/17/2009
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