Gateway Pediatric Therapy LLC
Behavior Analyst in Bingham Farms, MI. Organization (NPI-2).
NPI number1962089425
StatusActive
Last updated in NPPESMar 29, 2021
Details
- NPI
- 1962089425
- Entity type
- Organization (NPI-2)
- Legal business name
- Gateway Pediatric Therapy LLC
- Organization subpart
- No
- Enumeration date
- Mar 29, 2021
- Certification date
- Mar 8, 2021
- Last updated
- Mar 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
Practice location
32100 Telegraph Rd Ste 205Bingham Farms, MI 48025-2454
Phone 248-712-4266 · Fax 248-712-4381
Mailing address
32100 Telegraph Rd Ste 205Bingham Farms, MI 48025-2454
Phone 248-712-4266 · Fax 248-712-4381
Authorized official
Michael Tatak
Ceo
2487124266
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