Healthcare Provider Details

I. General information

NPI: 1235646712
Provider Name (Legal Business Name): BERNADETTE DAWN LATUCH JD, PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BERNADETTE DAWN O'KOON MA, JD

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CARDIFF RD
PITTSBURGH PA
15237-2834
US

IV. Provider business mailing address

103 CARDIFF RD
PITTSBURGH PA
15237-2834
US

V. Phone/Fax

Practice location:
  • Phone: 502-640-2463
  • Fax:
Mailing address:
  • Phone: 502-640-2463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS019857
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: