Provider Demographics
NPI:1144898214
Name:MICHEL, SOPHIE KATE
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:KATE
Last Name:MICHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20410 OBSERVATION DRIVE SUITE 108
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6419
Mailing Address - Country:US
Mailing Address - Phone:240-296-5862
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR STE 108
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6419
Practice Address - Country:US
Practice Address - Phone:240-296-5862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health