Provider Demographics
NPI:1255689378
Name:SAMBATARO, MIA FRANCESCA (CERTIFIED COUNSELOR)
Entity Type:Individual
Prefix:MISS
First Name:MIA
Middle Name:FRANCESCA
Last Name:SAMBATARO
Suffix:
Gender:F
Credentials:CERTIFIED COUNSELOR
Other - Prefix:MISS
Other - First Name:MIA
Other - Middle Name:FRANCESCA
Other - Last Name:SAMBATARO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CERTIFIED COUNSELOR
Mailing Address - Street 1:4501 N FOXGLOVE DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-9044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5727 BAKER WAY NW STE 101
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5811
Practice Address - Country:US
Practice Address - Phone:253-358-3347
Practice Address - Fax:253-358-3347
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor