Provider Demographics
NPI:1902380025
Name:NEE, MICHAELA CAMERON
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:CAMERON
Last Name:NEE
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 1:50 ALDRIN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4827
Mailing Address - Country:US
Mailing Address - Phone:508-688-9922
Mailing Address - Fax:
Practice Address - Street 1:25 ARMORY RD
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-5510
Practice Address - Country:US
Practice Address - Phone:508-688-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician