MEDICARE: GWENDOLYN MCDONALD MA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1811135528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWENDOLYN MCDONALD MA

Provider Business Mailing Address
First Line	:	208 ROBIN HOOD DRIVE
Second Line	:
City	:	IRWIN
State	:	PA
Zip	:	15642
Country	:	US
Telephone Number	:	724-861-9200
Fax Number	:	724-861-5926

Provider Business Practice Location Address
First Line	:	8960 HILL DR
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-3112
Country	:	US
Telephone Number	:	724-861-9200
Fax Number	:	724-861-5926

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

Provider Enumeration Date	:	02/03/2009
Last Update Date	:	02/03/2009

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Directions to “ GWENDOLYN MCDONALD MA” Practice Location

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