Provider Demographics
NPI:1477675627
Name:HAY, MICHELLE P (LICAC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:P
Last Name:HAY
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SOUTH ST
Mailing Address - Street 2:SUITE 301 A
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3594
Mailing Address - Country:US
Mailing Address - Phone:617-501-2588
Mailing Address - Fax:
Practice Address - Street 1:32 SOUTH ST
Practice Address - Street 2:SUITE 301 A
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3594
Practice Address - Country:US
Practice Address - Phone:617-501-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219527171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist