Provider Demographics
NPI:1689886988
Name:MICHAELES, GAY (RN,MS,CS)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:
Last Name:MICHAELES
Suffix:
Gender:F
Credentials:RN,MS,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CHURCH ST
Mailing Address - Street 2:SUITE3
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-3805
Mailing Address - Country:US
Mailing Address - Phone:150-839-3575
Mailing Address - Fax:150-839-3611
Practice Address - Street 1:10 CHURCH ST
Practice Address - Street 2:SUITE3
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-3805
Practice Address - Country:US
Practice Address - Phone:150-839-3575
Practice Address - Fax:150-839-3611
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1577744163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health