Provider Demographics
NPI:1831612878
Name:GATTO, MICHELLE (MS,CCDP-D, LBS)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:GATTO
Suffix:
Gender:F
Credentials:MS,CCDP-D, LBS
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:GATTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,CCDP-D, LBS
Mailing Address - Street 1:PO BOX 4160
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-0560
Mailing Address - Country:US
Mailing Address - Phone:610-224-8272
Mailing Address - Fax:
Practice Address - Street 1:1011 REED AVENUE
Practice Address - Street 2:SUITE 900
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-939-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BH002356103K00000X
PABH002356103K00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty