Provider Demographics
NPI:1972241123
Name:BARATTA, MICHAELA ROCHELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ROCHELLE
Last Name:BARATTA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N JAMES ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2844
Mailing Address - Country:US
Mailing Address - Phone:315-337-7952
Mailing Address - Fax:315-337-0991
Practice Address - Street 1:107 E CHESTNUT ST STE 104
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2834
Practice Address - Country:US
Practice Address - Phone:315-337-7952
Practice Address - Fax:315-337-0991
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031573235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist