| NPI | 1598136665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANNEN STAHLEY-LAKE Psychologist 724-465-2311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS015411) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS017929) |
| 1041C0700X Social Worker Clinical (Licence: PA CW017359) | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |