| NPI | 1508933599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE BLOUGH Credentialing 724-438-3011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: PA 422020) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA 422020) |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: PA 422020) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA 422020) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA 422020) | |
| 251B00000X Case Management (Licence: PA 422020) | |
| 251K00000X Public Health or Welfare (Licence: PA 436220) | |
| 251S00000X Community/Behavioral Health (Licence: PA 422020) | |
| 251S00000X Community/Behavioral Health (Licence: PA 436220) | |
| 261Q00000X Clinic/Center (Licence: PA 422020) | |
| 261Q00000X Clinic/Center (Licence: PA 332090) | |
| 261Q00000X Clinic/Center (Licence: PA 332080) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: PA 422020) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: PA 436220) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PA 422020) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-07-16 |