Provider Demographics
NPI:1518643121
Name:MICHEL, FABIOLA RUTH
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:RUTH
Last Name:MICHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COLEUS PARK
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02121-2006
Mailing Address - Country:US
Mailing Address - Phone:857-241-7019
Mailing Address - Fax:
Practice Address - Street 1:6 COLEUS PARK
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02121-2006
Practice Address - Country:US
Practice Address - Phone:857-241-7019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program