Healthcare Provider Details
I. General information
NPI: 1457425621
Provider Name (Legal Business Name): KENNETH BRIAN TORMEY PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10700 FRANKSTOWN RD SUITE 200
PITTSBURGH PA
15235-3049
US
IV. Provider business mailing address
342 BIRCH AVE
PITTSBURGH PA
15228-2377
US
V. Phone/Fax
- Phone: 412-247-5780
- Fax: 412-247-1099
- Phone: 412-343-3123
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PS008950L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: