Provider Demographics
NPI:1831299957
Name:BRANCH, MICHELE DALLAIRE (MS)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:DALLAIRE
Last Name:BRANCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VALLEY VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-2719
Mailing Address - Country:US
Mailing Address - Phone:845-986-8217
Mailing Address - Fax:
Practice Address - Street 1:95 CRYSTAL RUN RD
Practice Address - Street 2:CRYSTAL RUN HEALTHCARE
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-7001
Practice Address - Country:US
Practice Address - Phone:845-703-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS