MEDICARE: JESSICA MAHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker		PA

General Provider Information

NPI Number	:	1790317410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MAHER

Provider Business Mailing Address
First Line	:	6164 COLLIE DR
Second Line	:
City	:	BETHEL PARK
State	:	PA
Zip	:	15102-3252
Country	:	US
Telephone Number	:	724-518-1650
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 REGIS AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-1430
Country	:	US
Telephone Number	:	412-294-7399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2020
Last Update Date	:	02/11/2020

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Directions to “ JESSICA MAHER ” Practice Location

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