Provider Demographics
NPI:1720577356
Name:GARITO, JEFFREY (BCBA,MA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GARITO
Suffix:
Gender:M
Credentials:BCBA,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CUMBERLAND PKWY STE 316
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5677
Mailing Address - Country:US
Mailing Address - Phone:844-588-4222
Mailing Address - Fax:717-775-3443
Practice Address - Street 1:39 TANNERY RD
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-9673
Practice Address - Country:US
Practice Address - Phone:844-588-4222
Practice Address - Fax:717-775-3443
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PABH003779103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst