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General NPI Number Information
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NPI Number | 1851341747
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Entity Type | Organization
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Legal Business Name | GERIATRIC PSYCHOLOGICAL ASSOCIATE INC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 04/04/2017
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Provider Practice Location Address
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Address Line | 122 EMERSON AVE
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City | PITTSBURGH
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State | PA
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Zip | 15215-3208
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Country | US
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Telephone | 412-782-3510
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Fax | 412-782-6860
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Provider Business Mailing Address
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Address Line | 122 EMERSON AVE
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City | PITTSBURGH
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State | PA
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Zip | 15215-3208
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Country | US
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Telephone | 412-782-3510
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Fax | 412-782-6860
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. WAYNE ANTHONY HOOVER
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Credential | PHD
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Telephone | 41278223510
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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 | 001741210
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License Number State | PA
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