Provider Demographics
NPI:1811135528
Name:MCDONALD, GWENDOLYN (MA)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 ROBIN HOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:IRWIN,
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:724-861-9200
Mailing Address - Fax:724-861-5926
Practice Address - Street 1:8960 HILL DR
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-3112
Practice Address - Country:US
Practice Address - Phone:724-861-9200
Practice Address - Fax:724-861-5926
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst