Provider Demographics
NPI:1790035301
Name:DULSKI, LORETTA BROYLES (LSW)
Entity Type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:BROYLES
Last Name:DULSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SECOND AVE.
Mailing Address - Street 2:
Mailing Address - City:PGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-3205
Mailing Address - Country:US
Mailing Address - Phone:412-331-7712
Mailing Address - Fax:
Practice Address - Street 1:211 NORTH WHITFIELD
Practice Address - Street 2:SUITE 780
Practice Address - City:PGH
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-331-7712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW007099L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health