Healthcare Provider Details

I. General information

NPI: 1558205187
Provider Name (Legal Business Name): KAYLEE E TATTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 STREETS RUN RD STE 402
PITTSBURGH PA
15236-2073
US

IV. Provider business mailing address

148 MARYAL DR
PITTSBURGH PA
15236-1950
US

V. Phone/Fax

Practice location:
  • Phone: 412-267-7211
  • Fax:
Mailing address:
  • Phone: 412-267-7211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: