Organization
RELATIONSHIP RESOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL L KORAIDO (PRACTICE MANAGER)
(412) 921-3908
Entity
Organization
Contact information
Practice address
969 GREENTREE RD STE 108, PITTSBURGH, PA 15220-3303
(412) 921-3908
(866) 229-3442
Mailing address
969 GREENTREE RD STE 108, PITTSBURGH, PA 15220-3303
(412) 921-3908
(866) 229-3442
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
MD422963
PA
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/11/2008
Last updated
05/12/2011
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