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1 Mellon Way Latrobe PA 15650-1197 | |
| (724) 537-1480 | |
| (724) 539-6353 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1 Mellon Way, Latrobe, Pennsylvania |
| Authorized Official Name and Position | Melissa L. Dishong (VICE PRESIDENT/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7248308500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 Mellon Way Latrobe PA 15650-1197 Ph: (724) 537-1480 | 1 Mellon Way Latrobe PA 15650-1197 Ph: (724) 537-1480 |
| NPI Number | 1407236813 |
|---|---|
| Provider Enumeration Date | 06/02/2015 |
| Last Update Date | 06/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407236813 | NPI | - | NPPES |
| 100761052 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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