Provider Demographics
NPI:1164448932
Name:GREMELSPACHER, AMELIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:
Last Name:GREMELSPACHER
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 1:110 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2685
Mailing Address - Country:US
Mailing Address - Phone:724-941-4070
Mailing Address - Fax:724-941-5083
Practice Address - Street 1:110 HIDDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2685
Practice Address - Country:US
Practice Address - Phone:724-941-4070
Practice Address - Fax:724-941-5083
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005269L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP11654Medicare UPIN
PA544793H5BMedicare ID - Type UnspecifiedMEDICARE BILLING NUMBER