| NPI | 1629614425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY DETORE Clinical Psychologist 724-834-8783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2019-11-27 |