Provider Demographics
NPI:1851923619
Name:GINGRICH, ROSE EGAN (MED, LBS, BCBA)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:EGAN
Last Name:GINGRICH
Suffix:
Gender:F
Credentials:MED, LBS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 WASHINGTON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2350
Mailing Address - Country:US
Mailing Address - Phone:412-319-7371
Mailing Address - Fax:866-902-6694
Practice Address - Street 1:363 VANADIUM RD STE 300
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1477
Practice Address - Country:US
Practice Address - Phone:412-489-6357
Practice Address - Fax:888-271-0474
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-20-44483103K00000X
PABH005302103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst