Provider Demographics
NPI:1285839225
Name:GUNSCHEL, MICHELLE ST AMAND (MED)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ST AMAND
Last Name:GUNSCHEL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SUMMER ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1213
Mailing Address - Country:US
Mailing Address - Phone:617-587-1500
Mailing Address - Fax:617-587-1577
Practice Address - Street 1:9 8TH ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6027
Practice Address - Country:US
Practice Address - Phone:508-990-0418
Practice Address - Fax:508-979-4580
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health