Provider Demographics
NPI:1205972692
Name:CLARA H GAUTIER
Entity type:Organization
Organization Name:CLARA H GAUTIER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:HOLT
Authorized Official - Last Name:GAUTIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-401-5054
Mailing Address - Street 1:342 SOUTH HIGHLAND AVE
Mailing Address - Street 2:11A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-5202
Mailing Address - Country:US
Mailing Address - Phone:412-401-5054
Mailing Address - Fax:
Practice Address - Street 1:211 N WHITFIELD ST
Practice Address - Street 2:SUITE 540 MEDICAL CENTER EAST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3039
Practice Address - Country:US
Practice Address - Phone:412-401-5054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty