Boberg, Michele Janine

Boberg, Michele Janine is an individual health care provider with primary practice located at 4607 N Wheeling Ave , Muncie IN 47304-1220. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Boberg, Michele Janine can be contacted via phone (765) 288-1110.

Contact Information

Primary practice address
4607 N Wheeling Ave Muncie IN 47304-1220
Phone: (765) 288-1110
Fax: (765) 288-4044
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041822A Indiana

Profile Details

NPI number 1053499749
LBN Legal business name Boberg, Michele Janine
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053499749 NPPES
Indiana Other 500867 VALUE OPTIONS
Indiana Other 000000316087 VALUE OPTIONS
Indiana MEDICAID 200451310 VALUE OPTIONS
Indiana Other 708119000 VALUE OPTIONS

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