Provider Demographics
NPI:1508635640
Name:HYPNOSIS412
Entity Type:Organization
Organization Name:HYPNOSIS412
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HYPNOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:CHT CPH
Authorized Official - Phone:412-219-3072
Mailing Address - Street 1:105 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-1149
Mailing Address - Country:US
Mailing Address - Phone:412-219-3072
Mailing Address - Fax:
Practice Address - Street 1:105 GRANT AVE
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:PA
Practice Address - Zip Code:15057-1149
Practice Address - Country:US
Practice Address - Phone:412-219-3072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)