Provider Demographics
NPI:1922039635
Name:BURNS, MICHELLE ELIZABETH (MICHELLE BURNS)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:BURNS
Suffix:
Gender:F
Credentials:MICHELLE BURNS
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:GAROFANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT, MTI
Mailing Address - Street 1:321 W. BEN WHITE BLVD.
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7087
Mailing Address - Country:US
Mailing Address - Phone:512-448-2266
Mailing Address - Fax:512-462-4525
Practice Address - Street 1:321 W. BEN WHITE BLVD.
Practice Address - Street 2:SUITE 203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7087
Practice Address - Country:US
Practice Address - Phone:512-448-2266
Practice Address - Fax:512-462-4525
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT008401225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist