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General NPI Number Information
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NPI Number | 1376040568
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Entity Type | Organization
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Legal Business Name | JANELLE MALOCH LLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 5908 BRYANT ST STE 5
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City | PITTSBURGH
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State | PA
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Zip | 15206-1606
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Country | US
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Telephone | 412-807-8975
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Fax |
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Provider Business Mailing Address
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Address Line | 5908 BRYANT ST STE 5
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City | PITTSBURGH
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State | PA
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Zip | 15206-1606
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Country | US
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Telephone | 570-885-4492
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | JANELLE K. MALOCH
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Credential | PH.D.
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Telephone | 412-807-8975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PS018370
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License Number State | PA
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