Healthcare Provider Details

I. General information

NPI: 1306768353
Provider Name (Legal Business Name): ISABEL ABALOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42627 GARFIELD RD STE 214
CLINTON TOWNSHIP MI
48038-5032
US

IV. Provider business mailing address

39698 MORAVIAN DR
CLINTON TOWNSHIP MI
48036-1561
US

V. Phone/Fax

Practice location:
  • Phone: 586-310-8158
  • Fax:
Mailing address:
  • Phone: 602-350-1076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: