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160 Southern Ave Pittsburgh PA 15211-1910 | |
| (412) 431-0711 | |
| (412) 431-0732 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 160 Southern Ave, Pittsburgh, Pennsylvania |
| Authorized Official Name and Position | Heather Kelly (PRACTICE MANAGER) |
| Authorized Official Contact | 4124310711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
160 Southern Ave Pittsburgh PA 15211-1910 Ph: (412) 431-0711 | 160 Southern Ave Pittsburgh PA 15211-1910 Ph: (412) 431-0711 |
| NPI Number | 1568566206 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568566206 | NPI | - | NPPES |
| 1502011 | Other | PA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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