Provider Demographics
NPI:1932255239
Name:CHABBOTT, MICHELLE MARIE (EDD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:CHABBOTT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 8TH ST SE
Mailing Address - Street 2:#301
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2802
Mailing Address - Country:US
Mailing Address - Phone:202-425-7262
Mailing Address - Fax:202-966-0293
Practice Address - Street 1:731 8TH ST SE
Practice Address - Street 2:#301
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2802
Practice Address - Country:US
Practice Address - Phone:202-425-7262
Practice Address - Fax:202-966-0293
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000360103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist