Provider Demographics
NPI:1841597531
Name:BASHE, ALLISON GARDNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:GARDNER
Last Name:BASHE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 VIP DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-6932
Mailing Address - Country:US
Mailing Address - Phone:724-934-3905
Mailing Address - Fax:724-934-3906
Practice Address - Street 1:117 VIP DR
Practice Address - Street 2:SUITE 310
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6932
Practice Address - Country:US
Practice Address - Phone:724-934-3905
Practice Address - Fax:724-934-3906
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016975103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical