Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS019451 | PA |
Y | 103T00000X | Psychologist | PS019451 | PA |
NPI | 1003571043 |
---|---|
Provider Name | Loren Pease |
First Address | Pittsburgh, PA 15213-2536 |
Second Address | Pittsburgh, PA 15224-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2021 |
Last Update Date | 04/11/2021 |