Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS016808 | PA |
Y | 103TC0700X | Clinical Psychologist | PS016808 | PA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PS016808 | PA |
NPI | 1093036568 |
---|---|
Provider Name | Dr. Andrew J Ward |
First Address | Coraopolis, PA 15108 |
Second Address | Coraopolis, PA 15108-1827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 18/06/2010 |