Provider Demographics
NPI:1265452767
Name:LABRADOR, MICHELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:LABRADOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5114
Mailing Address - Country:US
Mailing Address - Phone:530-885-4888
Mailing Address - Fax:530-885-7059
Practice Address - Street 1:144 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5114
Practice Address - Country:US
Practice Address - Phone:530-885-4888
Practice Address - Fax:530-885-7059
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS87161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical