Provider Demographics
NPI:1851924732
Name:ISAAC, MICHELLE (MA ED)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:ISAAC
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 SHELTER BAY DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-1854
Mailing Address - Country:US
Mailing Address - Phone:407-962-7205
Mailing Address - Fax:
Practice Address - Street 1:111 E MONUMENT AVE UNIT 412
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5774
Practice Address - Country:US
Practice Address - Phone:407-930-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor