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General NPI Number Information
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NPI Number | 1407347545
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Entity Type | Individual
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Provider Name | MICHELLE C CAPOZZOLI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 05/24/2018
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Provider Practice Location Address
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Address Line | 115 MILL STREET MAILSTOP 234
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City | BELMONT
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State | MA
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Zip | 02478
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Country | US
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Telephone | 617-855-3183
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Fax |
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Provider Business Mailing Address
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Address Line | 2656 ENGLISH OAKS CIR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8268
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Country | US
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Telephone | 814-574-0461
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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