Individual
MARY JO PISANO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5850 ELLSWORTH AVE, SUITE 210, PITTSBURGH, PA 15232-1775
(412) 661-2036
(412) 422-8807
Mailing address
5850 ELLSWORTH AVE, SUITE 210, PITTSBURGH, PA 15232-1775
(412) 661-2036
(412) 422-8807
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-003176-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135513
HIGHMARK PROVIDER #
PA
Enumeration date
06/05/2006
Last updated
07/08/2007
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