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General NPI Number Information
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NPI Number | 1063626828
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Entity Type | Individual
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Provider Name | CAROL A PATTERSON M.ED.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 161 OLD STATE ROUTE 30 UNIT 14
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City | GREENSBURG
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State | PA
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Zip | 15601-7553
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Country | US
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Telephone | 724-836-3980
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Fax | 724-850-8441
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Provider Business Mailing Address
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Address Line | PO BOX 608
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City | GREENSBURG
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State | PA
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Zip | 15601-0608
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Country | US
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Telephone | 724-836-3980
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Fax | 724-850-8441
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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 | 003173
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License Number State | PA
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