Provider Demographics
NPI:1841902822
Name:FITE, MICHAELA JACQUELINE
Entity type:Individual
Prefix:MISS
First Name:MICHAELA
Middle Name:JACQUELINE
Last Name:FITE
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 1:125 TYSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2414
Mailing Address - Country:US
Mailing Address - Phone:610-550-6388
Mailing Address - Fax:
Practice Address - Street 1:1205 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5635
Practice Address - Country:US
Practice Address - Phone:484-266-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health