Provider Demographics
NPI:1740239284
Name:SZELES, HERMINA (PHD)
Entity Type:Individual
Prefix:
First Name:HERMINA
Middle Name:
Last Name:SZELES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:HERMINA
Other - Middle Name:
Other - Last Name:SZECSEI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:10475 PERRY HIGHWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:724-612-4025
Mailing Address - Fax:
Practice Address - Street 1:10475 PERRY HIGHWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:724-612-4025
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008790L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018171500002Medicaid
PA7949354OtherAETNA
PA347327OtherHIGHMARK BLUE CROSS
PA7949354OtherAETNA
PA0018171500002Medicaid