| Gateway Pediatric Therapy Llc | |
|
32100 Telegraph Rd Ste 205 Bingham Farms MI 48025-2454 | |
| (248) 712-4266 | |
| (248) 712-4381 |
| Full Name | Gateway Pediatric Therapy Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 32100 Telegraph Rd Ste 205, Bingham Farms, Michigan |
| Authorized Official Name and Position | Michael Tatak (CEO) |
| Authorized Official Contact | 2487124266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Pediatric Therapy Llc 32100 Telegraph Rd Ste 205 Bingham Farms MI 48025-2454 Ph: (248) 712-4266 | Gateway Pediatric Therapy Llc 32100 Telegraph Rd Ste 205 Bingham Farms MI 48025-2454 Ph: (248) 712-4266 |
| NPI Number | 1962089425 |
|---|---|
| Provider Enumeration Date | 03/29/2021 |
| Last Update Date | 03/29/2021 |
| Certification Date | 03/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962089425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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