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General NPI Number Information
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NPI Number | 1760155030
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Entity Type | Individual
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Provider Name | MARTA SUZANNE MCCLINTOCK-COMEAUX PHD, MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 07/31/2021
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Last Update Date | 07/31/2021
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Provider Practice Location Address
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Address Line | 363 VANADIUM RD STE 105
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City | PITTSBURGH
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State | PA
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Zip | 15243-1477
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Country | US
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Telephone | 412-368-2211
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Fax | 412-279-1418
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Provider Business Mailing Address
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Address Line | 237 CHEROKEE RD
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City | PITTSBURGH
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State | PA
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Zip | 15241-1515
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Country | US
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Telephone | 412-310-5098
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Fax | 412-279-1418
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW013727L
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License Number State | PA
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