Healthcare Provider Details

I. General information

NPI: 1316863020
Provider Name (Legal Business Name): LYNN KISELICA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 WILLIAM FLYNN HWY STE 300
ALLISON PARK PA
15101-3601
US

IV. Provider business mailing address

3960 WILLIAM FLYNN HWY STE 300
ALLISON PARK PA
15101-3601
US

V. Phone/Fax

Practice location:
  • Phone: 412-486-2948
  • Fax:
Mailing address:
  • Phone: 412-486-2948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS020779
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: