Provider Demographics
NPI:1174234157
Name:MANN, MICHELLE (CSM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:CSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 W CARLETON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-9458
Mailing Address - Country:US
Mailing Address - Phone:517-437-0114
Mailing Address - Fax:517-437-0033
Practice Address - Street 1:3200 W CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-9458
Practice Address - Country:US
Practice Address - Phone:517-437-0114
Practice Address - Fax:517-437-0033
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty