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Organization
COMMUNITY DIAGNOSTIC CENTER FOR CHILDREN
Active
Organization
COMMUNITY DIAGNOSTIC CENTER FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA WALTERS PHD, NCSP (OWNER)
(412) 654-8263
Entity
Organization
Contact information
Practice address
160 N CRAIG ST STE 118, PITTSBURGH, PA 15213-2714
(412) 654-8263
Mailing address
332 W PENN PL, PITTSBURGH, PA 15224-2224
(412) 654-8263
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
NULL
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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