Provider Demographics
NPI:1053578013
Name:ATTILIO, MICHELE
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:ATTILIO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 VALLEY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3551
Mailing Address - Country:US
Mailing Address - Phone:973-626-0363
Mailing Address - Fax:973-706-8689
Practice Address - Street 1:600 VALLEY RD STE 202
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3551
Practice Address - Country:US
Practice Address - Phone:973-626-0363
Practice Address - Fax:973-706-8689
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00310700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional