Provider Demographics
NPI:1275507683
Name:MACHINIST, LOUISE S (MA)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:S
Last Name:MACHINIST
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FORT COUCH ROAD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1041
Mailing Address - Country:US
Mailing Address - Phone:412-831-0355
Mailing Address - Fax:412-854-5152
Practice Address - Street 1:180 FORT COUCH ROAD
Practice Address - Street 2:SUITE 304
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1041
Practice Address - Country:US
Practice Address - Phone:412-831-0355
Practice Address - Fax:412-854-5152
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002484L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S34629Medicare UPIN
PAMA723161Medicare ID - Type Unspecified