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General NPI Number Information
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NPI Number | 1205972692
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Entity Type | Organization
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Legal Business Name | CLARA H GAUTIER
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 211 N WHITFIELD ST SUITE 540 MEDICAL CENTER EAST
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City | PITTSBURGH
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State | PA
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Zip | 15206-3039
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Country | US
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Telephone | 412-401-5054
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Fax |
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Provider Business Mailing Address
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Address Line | 342 SOUTH HIGHLAND AVE 11A
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City | PITTSBURGH
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State | PA
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Zip | 15206-5202
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Country | US
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Telephone | 412-401-5054
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Fax |
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Authorized Official
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Title or Position | SOLE PROPIETOR
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Name | DR. CLARA HOLT GAUTIER
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Credential | PH.D.
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Telephone | 412-401-5054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS016051
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License Number State | PA
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