Basic Information
| Provider Information | |||||||||
| NPI: | 1972241123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARATTA | ||||||||
| FirstName: | MICHAELA | ||||||||
| MiddleName: | ROCHELLE | ||||||||
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| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 N JAMES ST | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134402844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153377952 | ||||||||
| FaxNumber: | 3153370991 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 E CHESTNUT ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134402834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153377952 | ||||||||
| FaxNumber: | 3153370991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2022 | ||||||||
| LastUpdateDate: | 05/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 031573 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.