MICHELLE ANNE WILDMAN (NPI# 1003962317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003962317 |
| Entity Type | Individual |
| Full Name | MICHELLE ANNE WILDMAN |
| Credential | OTRL |
| Practice Address |
122 Eglin Pkwy Ne Fort Walton Beach FL 32548-4917 |
| Mailing Address |
852 Radford Ct Shalimar FL 32579-2169 |
| Practice Telephone | 8505436227 |
| Practice Fax Number | 8508639974 |
| Mailing Telephone | 8505436227 |
| Mailing Fax Number | 8508639974 |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 11903 | FL | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396994414 | Michelle Wildman | Pharmacist | 5601 Fishers Ln, Bethesda, MD 20892-0001 | 2008-09-12 |
| Street Address |
122 EGLIN PKWY NE |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32548-4917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225180060 | Catherine Riley | Speech-Language Pathologist | 122 Eglin Pkwy Ne, Fort Walton Beach, FL 32548-4917 | 2007-01-18 |
| 1770043366 | Margaret Lummus | Hearing Instrument Specialist | 122 Eglin Pkwy Ne, Fort Walton Beach, FL 32548-4917 | 2019-03-21 |
| 1700107448 | Mary Miller Tatum | Speech-Language Pathologist | 122 Eglin Pkwy Ne, Fort Walton Beach, FL 32548-4917 | 2010-06-16 |
| 1548598204 | Michelle Wildman, Occupational Therapist, P.a. | Day Training, Developmentally Disabled Services | 122 Eglin Pkwy Ne, Fort Walton Beach, FL 32548-4917 | 2009-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718426 | Erica Darby | Pharmacist | Publix, 421 Mary Esther Cut Off, Fort Walton Beach, FL 32548 | 2020-07-30 |
| 1770136681 | Michael Cody Jones | Pharmacist | 251 Miacle Strip Pkwy Se, Fort Walton Beach, FL 32548 | 2019-07-19 |
| 1346714532 | Alison Ann Gould | Occupational Therapy Assistant | Emerald Coast Heath Care, 114 Third St, Fort Walton Beach, FL 32548 | 2019-01-22 |
| 1699217695 | Mayra Lopez | Dentist | Blvd. Gomez Morin #8569, Suite 6a, Juarez, CHIHUAHUA 32548 | 2016-11-08 |
| 1265808455 | Rajiv Tuladhar Dmd Holdings, Pllc | Dentist | 516 Mary Esther Blvd Ste 2, Fort Walton Beach, FL 32548 | 2015-08-11 |
| 1881090702 | Annette Peadro | Behavioral Analyst | 171 Brooks St, Suite 308, Fort Walton Beach, FL 32548 | 2014-11-05 |
| 1790037729 | Julie Bradfield | Counselor | 44 Shell Ave, Fort Walton Beach, FL 32548 | 2012-10-15 |
| 1740559582 | Beth Paula Ritenour | Pharmacist | 414 Mary Esther Cutoff Nw, C, Fort Walton Beach, FL 32548 | 2011-12-23 |
| 1891080867 | Okaloosa County Council On Aging | Home Health | 207 Hospital Drive, Fort Walton Beach, FL 32548 | 2011-06-17 |
| 1649580275 | Sharon Renee Wise | Counselor | 44 Shell Avenue Se, Fort Walton Beach, FL 32548 | 2010-10-17 |
| Find all providers in zip 32548 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518038256 | Horizons of Okaloosa County, Inc. | Day Training, Developmentally Disabled Services | 123 Truxton Ave, Fort Walton Beach, FL 32547-2460 | 2006-11-13 |
| 1548598204 | Michelle Wildman, Occupational Therapist, P.a. | Day Training, Developmentally Disabled Services | 122 Eglin Pkwy Ne, Fort Walton Beach, FL 32548-4917 | 2009-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528361 | Where The Heart Is Home Care Services LLC | Day Training, Developmentally Disabled Services | 110 E Broad St Apt 204, Tampa, FL 33604-4132 | 2020-11-04 |
| 1801496674 | Brandon Martinez | Day Training, Developmentally Disabled Services | 1884 Sw 81st Way, Davie, FL 33324-4609 | 2020-10-29 |
| 1639779721 | The Unique Way LLC | Day Training, Developmentally Disabled Services | 1025 S Ohio Ave Apt 15, Lakeland, FL 33803-1283 | 2020-10-28 |
| 1821696394 | Devotion of Care LLC | Day Training, Developmentally Disabled Services | 1801 Nw 3rd St, Pompano Beach, FL 33069-2756 | 2020-10-15 |
| 1538767298 | Healthy Group Home Project, LLC. | Day Training, Developmentally Disabled Services | 849 Mulberry Ave, Panama City, FL 32401-2556 | 2020-10-15 |
| 1902404742 | Brite Life Adult Training Program, LLC | Day Training, Developmentally Disabled Services | 1300 Nw 95th St, Miami, FL 33147-3320 | 2020-10-14 |
| 1134727845 | Four Seasons Aba | Day Training, Developmentally Disabled Services | 6 Meridian Home Ln, Palm Coast, FL 32137-2402 | 2020-10-14 |
| 1760089429 | Helping Angels Thrive, Inc. | Day Training, Developmentally Disabled Services | 305 Providence Rd Apt 101, Brandon, FL 33511-4739 | 2020-10-06 |
| 1245847268 | Joshua R Grant | Day Training, Developmentally Disabled Services | 2405 Almeda St, Jacksonville, FL 32209-4632 | 2020-09-24 |
| 1417562257 | Peace of Mind Home Care Services | Day Training, Developmentally Disabled Services | 1102 Ray Charles Blvd Unit 314, Tampa, FL 33602-3050 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32548 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.