Provider Demographics
NPI:1043769607
Name:SPRUNG, MOLLIE (PHD)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:
Last Name:SPRUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VAPHCS UNIVERSITY DRIVE C
Mailing Address - Street 2:MAIL CODE 116-G (BH)
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240-1001
Mailing Address - Country:US
Mailing Address - Phone:585-732-9605
Mailing Address - Fax:
Practice Address - Street 1:VAPHCS UNIVERSITY DRIVE C
Practice Address - Street 2:MAIL CODE 116-G (BH)
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1001
Practice Address - Country:US
Practice Address - Phone:585-732-9605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018160103TC0700X
PA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist