Provider Demographics
NPI:1588851851
Name:GAUTIER, CLARA HOLT (PHD)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:HOLT
Last Name:GAUTIER
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 1:128 N CRAIG ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2758
Mailing Address - Country:US
Mailing Address - Phone:412-401-5054
Mailing Address - Fax:
Practice Address - Street 1:128 N CRAIG ST STE 210
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2758
Practice Address - Country:US
Practice Address - Phone:412-401-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical