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General NPI Number Information
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NPI Number | 1568116879
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Entity Type | Organization
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Legal Business Name | PERSONAL POWER THERAPY
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Dates
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Enumeration Date | 02/05/2022
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Last Update Date | 02/05/2022
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Provider Practice Location Address
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Address Line | 1141 S BRADDOCK AVE
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City | PITTSBURGH
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State | PA
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Zip | 15218-1250
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Country | US
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Telephone | 724-991-8351
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Fax |
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Provider Business Mailing Address
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Address Line | 6504 ROSEMOOR ST
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City | PITTSBURGH
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State | PA
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Zip | 15217-3026
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Country | US
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Telephone | 724-991-8351
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | CASEY CALLENDER
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Credential | LPC
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Telephone | 724-991-8351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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