Healthcare Provider Details

I. General information

NPI: 1154086080
Provider Name (Legal Business Name): GABRIELLA MANTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WYNNEWOOD AVE
SINKING SPRING PA
19608-1344
US

IV. Provider business mailing address

20 WYNNEWOOD AVE
SINKING SPRING PA
19608-1344
US

V. Phone/Fax

Practice location:
  • Phone: 484-793-5911
  • Fax:
Mailing address:
  • Phone: 484-793-5911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC017429
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: