Healthcare Provider Details

I. General information

NPI: 1689459216
Provider Name (Legal Business Name): PALMER ROVINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FORBES AVE
PITTSBURGH PA
15219-3016
US

IV. Provider business mailing address

6487 CENTRE AVE
PITTSBURGH PA
15206-3883
US

V. Phone/Fax

Practice location:
  • Phone: 484-926-9086
  • Fax:
Mailing address:
  • Phone: 484-926-9086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: