Provider Demographics
NPI:1144487166
Name:STOLOW, MICHELLE (MAT, IBCLC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:STOLOW
Suffix:
Gender:F
Credentials:MAT, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-1753
Mailing Address - Country:US
Mailing Address - Phone:978-897-3637
Mailing Address - Fax:
Practice Address - Street 1:27 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-1753
Practice Address - Country:US
Practice Address - Phone:978-897-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN