| Doctor Name: | MICHELLE R. CONDRY |
| NPI Number: | 1134315724 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | SW8414 |
| Business Practice Address: | 1389 S Us Highway 301 Sumterville, FL - 335855143 |
| Business Phone Number: | 3527935900 |
| Business Fax Number: | 3527939558 |
| Mailing Address: | 1425 S Us Highway 301, SUMTERVILLE |
| State: | FL |
| Postal Code: | 335855141 |
| Phone Number: | 3527935900 |
| Fax Number: | 3527938050 |
| NPI Enumeration Date: | 09/18/2007 |
| NPI Last Update Date: | 11/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW8414 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |