Provider Demographics
NPI:1376648352
Name:GREENWALD, DEBORAH AYN (PHD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:AYN
Last Name:GREENWALD
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 1:1326 FREEPORT RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3131
Mailing Address - Country:US
Mailing Address - Phone:412-967-0610
Mailing Address - Fax:412-968-0527
Practice Address - Street 1:1326 FREEPORT RD
Practice Address - Street 2:SUITE 250
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3131
Practice Address - Country:US
Practice Address - Phone:412-967-0610
Practice Address - Fax:412-968-0527
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002969L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical