Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS017420 | PA |
Y | 103TC0700X | Clinical Psychologist | PS017420 | PA |
NPI | 1013103241 |
---|---|
Provider Name | Carla Mayorga Alvarez |
First Address | Pittsburgh, PA 15212-5255 |
Second Address | Pittsburgh, PA 15212-5255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2007 |
Last Update Date | 29/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102926189 | (05) | PA |