Provider Demographics
NPI:1205919925
Name:DEINES, DECHANTAL MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:DECHANTAL
Middle Name:MARIE
Last Name:DEINES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CHANTAL
Other - Middle Name:MARIE
Other - Last Name:DEINES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:232 N CRAIG ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1512
Mailing Address - Country:US
Mailing Address - Phone:412-687-0700
Mailing Address - Fax:412-687-0711
Practice Address - Street 1:232 N CRAIG ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1512
Practice Address - Country:US
Practice Address - Phone:412-687-0700
Practice Address - Fax:412-687-0711
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015466103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical