Healthcare Provider Details

I. General information

NPI: 1710423876
Provider Name (Legal Business Name): SHAQUALA TOWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BINGHAM ST
PITTSBURGH PA
15203-1101
US

IV. Provider business mailing address

1011 BINGHAM ST
PITTSBURGH PA
15203-1101
US

V. Phone/Fax

Practice location:
  • Phone: 412-651-3957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: