Provider Demographics
NPI:1679210116
Name:GATT, HALEY JEAN
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:JEAN
Last Name:GATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11218 HILLMAN
Mailing Address - Street 2:
Mailing Address - City:DAVISBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48350-3508
Mailing Address - Country:US
Mailing Address - Phone:248-930-3154
Mailing Address - Fax:
Practice Address - Street 1:11218 HILLMAN
Practice Address - Street 2:
Practice Address - City:DAVISBURG
Practice Address - State:MI
Practice Address - Zip Code:48350-3508
Practice Address - Country:US
Practice Address - Phone:248-930-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program