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General NPI Number Information
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NPI Number | 1154880078
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Entity Type | Individual
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Provider Name | ANGUS K MARTINDALE MSPC
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Gender | Male
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 3960 WILLIAM FLYNN HWY STE 300
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City | ALLISON PARK
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State | PA
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Zip | 15101-3601
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Country | US
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Telephone | 412-527-5463
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Fax |
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Provider Business Mailing Address
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Address Line | 3021 WOODLAND RD
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City | AMBRIDGE
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State | PA
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Zip | 15003-1349
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Country | US
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Telephone | 412-527-5463
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC013125
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License Number State | PA
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