Provider Demographics
NPI:1609200153
Name:DEAN, SALLY ANNE (MS)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:ANNE
Last Name:DEAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 JONQUIL PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2561
Mailing Address - Country:US
Mailing Address - Phone:412-341-2928
Mailing Address - Fax:
Practice Address - Street 1:377 JONQUIL PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2561
Practice Address - Country:US
Practice Address - Phone:412-341-2928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000201103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst