Provider Demographics
NPI:1740607746
Name:MACMICHAEL, FIONA
Entity Type:Individual
Prefix:
First Name:FIONA
Middle Name:
Last Name:MACMICHAEL
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 1:5137 S LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2595
Mailing Address - Country:US
Mailing Address - Phone:863-666-4802
Mailing Address - Fax:
Practice Address - Street 1:5137 S LAKELAND DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2595
Practice Address - Country:US
Practice Address - Phone:863-666-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker