Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS015099 | PA |
Y | 103T00000X | Psychologist | PS015099 | PA |
NPI | 1013029750 |
---|---|
Provider Name | Dr. Stacey Wettstein |
First Address | Pittsburgh, PA 15206-4409 |
Second Address | Pittsburgh, PA 15206-4409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |