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NPI 1689749384

NPI 1689749384 : GERALD LEE CIPKALA-GAFFIN PH.D. : WEXFORD, PA

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General NPI Number Information
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    NPI Number           |    1689749384
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    Entity Type          |    Individual 
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    Provider Name        |    GERALD LEE CIPKALA-GAFFIN PH.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/21/2006
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    Last Update Date     |    08/25/2026
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Provider Practice Location Address
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    Address Line         |    2523 MATTERHORN DR 
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    City                 |    WEXFORD
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    State                |    PA
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    Zip                  |    15090-7963
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    Country              |    US
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    Telephone            |    412-916-7287
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    Fax                  |    724-940-2363
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Provider Business Mailing Address
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    Address Line         |    2523 MATTERHORN DR 
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    City                 |    WEXFORD
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    State                |    PA
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    Zip                  |    15090-7963
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    Country              |    US
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    Telephone            |    724-940-2363
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    Fax                  |    724-940-2363
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    PS006097L
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    103TC2200X
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    Taxonomy Name        |    Clinical Child & Adolescent Psychologist
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    License Number       |    PS006097L
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    License Number State |    PA
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Taxonomy #3
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    PS006097L
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    License Number State |    PA
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Taxonomy #4
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    Taxonomy Code        |    103TA0700X
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    Taxonomy Name        |    Adult Development & Aging Psychologist
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    License Number       |    PS006097L
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    License Number State |    PA
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Taxonomy #5
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    Taxonomy Code        |    103TA0700X
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    Taxonomy Name        |    Adult Development & Aging Psychologist
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    License Number       |    4793
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    License Number State |    OH
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Taxonomy #6
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    4793
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    License Number State |    OH
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Taxonomy #7
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    4793
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    License Number State |    OH
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Taxonomy #8
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    Taxonomy Code        |    103TC2200X
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    Taxonomy Name        |    Clinical Child & Adolescent Psychologist
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    License Number       |    4793
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    License Number State |    OH
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