Healthcare Provider Details

I. General information

NPI: 1134242936
Provider Name (Legal Business Name): JANET DEVEBER MARLAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4527 WINTHROP ST
PITTSBURGH PA
15213-3722
US

IV. Provider business mailing address

5400 HOBART ST
PITTSBURGH PA
15217-1921
US

V. Phone/Fax

Practice location:
  • Phone: 412-621-3170
  • Fax:
Mailing address:
  • Phone: 412-422-2462
  • Fax: 412-422-5451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS 002740 L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: