Provider Demographics
NPI:1598371759
Name:MCCRAY, DINETTA HOPE (MSG003044)
Entity Type:Individual
Prefix:MRS
First Name:DINETTA
Middle Name:HOPE
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:MSG003044
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7913 THON DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-1548
Mailing Address - Country:US
Mailing Address - Phone:412-612-6247
Mailing Address - Fax:412-723-2156
Practice Address - Street 1:7913 THON DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-1548
Practice Address - Country:US
Practice Address - Phone:412-612-6247
Practice Address - Fax:412-723-2156
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003044225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist