Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1881141133 |
---|---|
Provider Name | Michelle Sullivan Fielding |
First Address | Ellwood City, PA 16117-1428 |
Second Address | Ellwood City, PA 16117-1428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2016 |
Last Update Date | 03/09/2016 |