Provider Demographics
NPI:1700410404
Name:CLAY, MICHELLE RENE (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:RENE
Last Name:CLAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19485
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70179-0485
Mailing Address - Country:US
Mailing Address - Phone:504-345-8671
Mailing Address - Fax:
Practice Address - Street 1:2623 URSULINES AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-3435
Practice Address - Country:US
Practice Address - Phone:504-345-8671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator