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General NPI Number Information
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NPI Number | 1508460395
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Entity Type | Individual
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Provider Name | CHRISTINA E MUTHARD-WHITE PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 5274 RTE 30 STE 10
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City | GREENSBURG
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State | PA
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Zip | 15601-7831
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Country | US
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Telephone | 724-216-0317
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Fax |
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Provider Business Mailing Address
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Address Line | 6619 RIDGEVILLE ST
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City | PITTSBURGH
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State | PA
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Zip | 15217-1314
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS019170
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License Number State | PA
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