Healthcare Provider Details

I. General information

NPI: 1124405089
Provider Name (Legal Business Name): NANCY CHUBB PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 KANSAS ST
VERONA PA
15147-2215
US

IV. Provider business mailing address

227 KANSAS ST
VERONA PA
15147-2215
US

V. Phone/Fax

Practice location:
  • Phone: 412-441-3313
  • Fax: 412-441-3324
Mailing address:
  • Phone: 412-441-3313
  • Fax: 412-441-3324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS007969L
License Number StatePA

VIII. Authorized Official

Name: DR. NANCY CHUBB
Title or Position: PRESIDENT
Credential: PHD, MBA
Phone: 412-441-3313