Provider Demographics
NPI:1447267620
Name:MICHNO, C. ANNE (PT, CHT)
Entity type:Individual
Prefix:
First Name:C.
Middle Name:ANNE
Last Name:MICHNO
Suffix:
Gender:F
Credentials:PT, CHT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:STADER
Other - Last Name:EDMONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,CHT
Mailing Address - Street 1:1400 FRONT AVE. SUITE 205
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:410-823-4263
Mailing Address - Fax:410-823-1861
Practice Address - Street 1:1400 FRONT AVE. SUITE 205
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-823-4263
Practice Address - Fax:410-823-1861
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD149822251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand