Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PS-00632 | PA |
NPI | 1033254198 |
---|---|
Provider Name | Dr. Louella Dias |
First Address | Pittsburgh, PA 15213-2744 |
Second Address | Pittsburgh, PA 15213-2744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |