Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS 3981-L | PA |
Y | 103TC0700X | Clinical Psychologist | PS 3981-L | PA |
N | 103G00000X | Clinical Psychologist | PS 3981-L | PA |
N | 103TC0700X | Clinical Psychologist | PS 3981-L | PA |
N | 103TR0400X | Rehabilitation Psychologist | PS 3981-L | PA |
NPI | 1730546730 |
---|---|
Provider Name | Michael Mccue |
First Address | Pittsburgh, PA 15233-2341 |
Second Address | Pittsburgh, PA 15233-2341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2016 |
Last Update Date | 21/01/2016 |