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General NPI Number Information
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NPI Number | 1003059726
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Entity Type | Individual
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Provider Name | MICHELLE HAINESWORTH PHD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 410 S MAPLE AVE
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City | GREENSBURG
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State | PA
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Zip | 15601-3221
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Country | US
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Telephone | 412-716-2646
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Fax |
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Provider Business Mailing Address
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Address Line | 207 SPRINGMONT DR
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City | WYOMISSING
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State | PA
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Zip | 19610-4014
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Country | US
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Telephone | 412-716-2646
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Fax | 610-750-7966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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