| Doctor Name: | MS. MICHELLE KATHLYN ENDERLIN |
| NPI Number: | 1063474377 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | C004357 |
| Business Practice Address: | 853 Wake Forest Business Park Ste I Wake Forest, NC - 275877185 |
| Business Phone Number: | 9195544027 |
| Business Fax Number: | |
| Mailing Address: | 2510 Garden Hill Dr Apt 208, RALEIGH |
| State: | NC |
| Postal Code: | 276146899 |
| Phone Number: | 9194147433 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2006 |
| NPI Last Update Date: | 03/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C004357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |