Healthcare Provider Details

I. General information

NPI: 1790026706
Provider Name (Legal Business Name): RESHEDA HOUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 5TH ST
TRAFFORD PA
15085-1018
US

IV. Provider business mailing address

304 5TH ST
TRAFFORD PA
15085-1018
US

V. Phone/Fax

Practice location:
  • Phone: 724-246-4862
  • Fax:
Mailing address:
  • Phone: 724-246-4862
  • Fax: 724-318-6812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0013221
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP030983
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP012537
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010831
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: