| NPI | 1295382380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN FALLON Owner 724-799-0262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC1900X Psychologist, Counseling | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |