Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist |
NPI | 1184728578 |
---|---|
Provider Name | Ms. Cathy Petchel |
First Address | Mcmurray, PA 15317-2571 |
Second Address | Mcmurray, PA 15317-2571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
516593 | BLUE SHIELD PROVIDER # (01) | PA |