Provider Demographics
NPI:1922896497
Name:MICHELLE MUENZENMEYER
Entity type:Organization
Organization Name:MICHELLE MUENZENMEYER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUENZENMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:616-795-0900
Mailing Address - Street 1:138 E 12300 S STE C-1014
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7976
Mailing Address - Country:US
Mailing Address - Phone:616-795-0900
Mailing Address - Fax:
Practice Address - Street 1:138 E 12300 S STE C-1014
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7976
Practice Address - Country:US
Practice Address - Phone:616-795-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty