Provider Demographics
NPI:1376600296
Name:COUFAL, DONNA (PHD PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:COUFAL
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 CENTRE AVE
Mailing Address - Street 2:SUITE L4
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3744
Mailing Address - Country:US
Mailing Address - Phone:412-362-8817
Mailing Address - Fax:412-362-0477
Practice Address - Street 1:5701 CENTRE AVE
Practice Address - Street 2:SUITE L4
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3744
Practice Address - Country:US
Practice Address - Phone:412-362-8817
Practice Address - Fax:412-362-0477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005359L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical