Provider Demographics
NPI:1336205384
Name:TEUTER, URSULA (PHD)
Entity Type:Individual
Prefix:DR
First Name:URSULA
Middle Name:
Last Name:TEUTER
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 1:3490 WASHINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1078
Mailing Address - Country:US
Mailing Address - Phone:412-812-1142
Mailing Address - Fax:412-220-3838
Practice Address - Street 1:316 STATION ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1833
Practice Address - Country:US
Practice Address - Phone:412-812-1142
Practice Address - Fax:412-220-3838
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005442L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075096Medicare UPIN