Provider Demographics
NPI:1811620024
Name:MICHALSKI, KATIE ANNE (MA, BSL)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANNE
Last Name:MICHALSKI
Suffix:
Gender:F
Credentials:MA, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3010
Mailing Address - Country:US
Mailing Address - Phone:717-560-7917
Mailing Address - Fax:717-560-6452
Practice Address - Street 1:390 WATERLOO BLVD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2624
Practice Address - Country:US
Practice Address - Phone:610-363-5500
Practice Address - Fax:610-363-6499
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005992103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst