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General NPI Number Information
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NPI Number | 1083826481
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Entity Type | Organization
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Legal Business Name | MT. LEBANON PSYCHOLOGICAL DIAGNOSTICS, INC
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Dates
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Enumeration Date | 05/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1725 WASHINGTON RD STE 404-C
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City | PITTSBURGH
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State | PA
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Zip | 15241-1207
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Country | US
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Telephone | 412-833-7444
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 WASHINGTON RD STE 404-C
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City | PITTSBURGH
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State | PA
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Zip | 15241-1207
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Country | US
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Telephone | 412-833-7444
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. ALLEN ANTHONY COBBETT
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Credential | PH.D.
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Telephone | 412-833-7444
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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 | PS 003752
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License Number State | PA
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