Provider Demographics
NPI:1023865714
Name:RICHARDS, MICHELLE LEYLA (MA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEYLA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 W RIDGE PIKE STE 1072ND
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1778
Mailing Address - Country:US
Mailing Address - Phone:484-938-8668
Mailing Address - Fax:
Practice Address - Street 1:168 W RIDGE PIKE STE 1072ND
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1778
Practice Address - Country:US
Practice Address - Phone:484-938-8668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health