Provider Demographics
NPI:1689939308
Name:CENTER FOR PEDIATRIC NEUROPSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:CENTER FOR PEDIATRIC NEUROPSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:EMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:412-343-6416
Mailing Address - Street 1:615 WASHINGTON RD
Mailing Address - Street 2:TERRACE LEVEL, SUITE 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1901
Mailing Address - Country:US
Mailing Address - Phone:412-343-6416
Mailing Address - Fax:412-343-6418
Practice Address - Street 1:615 WASHINGTON RD
Practice Address - Street 2:TERRACE LEVEL, SUITE 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1901
Practice Address - Country:US
Practice Address - Phone:412-343-6416
Practice Address - Fax:412-343-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016120251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health