Provider Demographics
NPI:1770571010
Name:GEHRIG, CAROL (M ED LICENSED PSYCHO)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:GEHRIG
Suffix:
Gender:F
Credentials:M ED LICENSED PSYCHO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 E MAIDEN ST
Mailing Address - Street 2:#31
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4964
Mailing Address - Country:US
Mailing Address - Phone:724-225-3444
Mailing Address - Fax:724-222-2189
Practice Address - Street 1:87 E MAIDEN ST
Practice Address - Street 2:#31
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4964
Practice Address - Country:US
Practice Address - Phone:724-225-3444
Practice Address - Fax:724-222-2189
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006654L103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral