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General NPI Number Information
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NPI Number | 1689939308
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Entity Type | Organization
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Legal Business Name | CENTER FOR PEDIATRIC NEUROPSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 615 WASHINGTON RD TERRACE LEVEL, SUITE 3
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City | PITTSBURGH
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State | PA
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Zip | 15228-1901
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Country | US
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Telephone | 412-343-6416
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Fax | 412-343-6418
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Provider Business Mailing Address
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Address Line | 615 WASHINGTON RD TERRACE LEVEL, SUITE 3
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City | PITTSBURGH
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State | PA
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Zip | 15228-1901
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Country | US
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Telephone | 412-343-6416
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Fax | 412-343-6418
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | DR. CHRISTY L. EMMONS
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Credential | PSY.D.
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Telephone | 412-343-6416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PS016120
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License Number State | PA
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