Individual
MRS. ILENE ELLEN FABISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
664 PEARL ST, BROCKTON, MA 02301-4527
(617) 759-7542
Mailing address
664 PEARL ST, BROCKTON, MA 02301-4527
(617) 759-7542
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/03/2009
Last updated
10/03/2009
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