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General NPI Number Information
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NPI Number | 1104264589
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Entity Type | Individual
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Provider Name | LISA LEE MICHAUD M.A.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 50 HOWE AVE
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City | MILLBURY
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State | MA
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Zip | 01527-3264
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Country | US
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Telephone | 508-865-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SHORE DR
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City | DRACUT
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State | MA
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Zip | 01826-2030
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Country | US
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Telephone | 978-726-1161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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