Doctor Name: | MICHELLE ABELLA |
NPI Number: | 1104015197 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D |
License Number: | 071007363 |
Business Practice Address: | 31480 N Us Highway 45 Libertyville, IL - 600489444 |
Business Phone Number: | 8476802715 |
Business Fax Number: | 8476803832 |
Mailing Address: | 31480 N Us Highway 45, LIBERTYVILLE |
State: | IL |
Postal Code: | 600489444 |
Phone Number: | 8476802715 |
Fax Number: | 8476803832 |
NPI Enumeration Date: | 10/16/2007 |
NPI Last Update Date: | 10/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 071007363 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |