Provider Demographics
NPI:1700970399
Name:GORSCAK, BONNIE JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:JEAN
Last Name:GORSCAK
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 1:128 N. CRAIG ST.
Mailing Address - Street 2:SUITE 211-C
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2758
Mailing Address - Country:US
Mailing Address - Phone:412-683-1667
Mailing Address - Fax:412-243-8319
Practice Address - Street 1:128 N. CRAIG ST.
Practice Address - Street 2:SUITE 211-C
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2758
Practice Address - Country:US
Practice Address - Phone:412-683-1667
Practice Address - Fax:412-243-8319
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-008104L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical