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Individual
MICHELE A GABOURY
Active
Individual
MICHELE A GABOURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
105122
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101867
MAGELLAN PROVIDER NUMBER
MA
01
—
105122
LICSW
MA
01
—
2073786
CIGNA PROVIDER NUMBER
MA
01
—
216598
MANAGED HEALTH NETWORK PR
MA
01
—
5144002
AETNA PROVIDER NUMBER
MA
01
—
766044
TUFTS PROVIDER NUMBER
MA
01
—
PO3284
BC/BS PROVIDER NUMBER
MA
Enumeration date
10/04/2006
Last updated
05/01/2015
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