Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PS016555 | PA |
N | 103TR0400X | Rehabilitation Psychologist | PS016555 | PA |
N | 103TS0200X | School Psychologist | PS016555 | PA |
NPI | 1265776942 |
---|---|
Provider Name | Heather J Ufberg |
First Address | Pittsburgh, PA 15217-1350 |
Second Address | Pittsburgh, PA 15236-5505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2012 |
Last Update Date | 24/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102782329-0001 | (05) | PA |