Provider Demographics
NPI:1033620588
Name:RABAS, MICHAELA ROSE (ATC)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ROSE
Last Name:RABAS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SILO CT
Mailing Address - Street 2:728B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-4972
Mailing Address - Country:US
Mailing Address - Phone:920-559-3251
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF SOUTH CAROLINA
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0001
Practice Address - Country:US
Practice Address - Phone:803-777-0169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer