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General NPI Number Information
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NPI Number | 1548679582
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Entity Type | Organization
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Legal Business Name | INTEGRATED PRACTITIONERS CENTER INC
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Dates
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Enumeration Date | 08/04/2014
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 200 MEDICAL ARTS BLDG SUITE 240 B
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City | KITTANNING
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State | PA
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Zip | 16201-7132
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Country | US
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Telephone | 814-648-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 268 MILE LONG HILL RD
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City | KITTANNING
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State | PA
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Zip | 16201-4724
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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 | PRESIDENT
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Name | LAURIE M TETRO
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Credential |
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Telephone | 814-648-0600
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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 |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | PA
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