Provider Demographics
NPI:1043445430
Name:DEPAOLO, MICHELLE S (MSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:DEPAOLO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3037
Mailing Address - Country:US
Mailing Address - Phone:215-285-2101
Mailing Address - Fax:
Practice Address - Street 1:55 LAUREL RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3037
Practice Address - Country:US
Practice Address - Phone:215-285-2101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health