Healthcare Provider Details

I. General information

NPI: 1124185822
Provider Name (Legal Business Name): MICHELE ANN REISS RN, PHD, CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 DELAFIELD RD SUITE 2030
PITTSBURGH PA
15215-3205
US

IV. Provider business mailing address

4230 MONTRACHET CT
ALLISON PARK PA
15101-2952
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-5590
  • Fax: 412-784-5274
Mailing address:
  • Phone: 412-784-5590
  • Fax: 412-784-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN214389L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: