Tisdale, Michele
Tisdale, Michele is an individual health care provider with primary practice located at 1300 Camino Sierra Vis 129, Santa Fe NM 87505-1007. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Tisdale, Michele can be contacted via phone (505) 467-2504.Contact Information
Primary practice address
1300 Camino Sierra Vis 129
Santa Fe NM 87505-1007
Phone: (505) 467-2504
Fax: (505) 467-2646
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 118 | New Mexico |
Profile Details
| NPI number | 1932232519 |
|---|---|
| LBN Legal business name | Tisdale, Michele |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932232519 | NPPES |
| New Mexico | MEDICAID | J4306 |
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