Healthcare Provider Details

I. General information

NPI: 1194410514
Provider Name (Legal Business Name): COURTNEY HANNAH WREGGET LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 KEWANNA AVE
PITTSBURGH PA
15234-1204
US

IV. Provider business mailing address

707 KEWANNA AVE
PITTSBURGH PA
15234-1204
US

V. Phone/Fax

Practice location:
  • Phone: 412-339-0794
  • Fax:
Mailing address:
  • Phone: 412-339-0794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014792
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: