Provider Demographics
NPI:1417246687
Name:SABATO, LISA M (BCBA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SABATO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 W GERMANTOWN PIKE
Mailing Address - Street 2:#2607
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1030
Mailing Address - Country:US
Mailing Address - Phone:267-804-2084
Mailing Address - Fax:
Practice Address - Street 1:666 W GERMANTOWN PIKE
Practice Address - Street 2:#2607
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1030
Practice Address - Country:US
Practice Address - Phone:267-804-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst