Individual
MR. GARY D YAQUINTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LIC PSYCHOLOGIST
Contact information
Practice address
272 LADDIE DR, WASHINGTON, PA 15301-1333
(724) 228-4986
Mailing address
272 LADDIE DR, WASHINGTON, PA 15301-1333
(724) 228-4986
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-004640-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YA517259
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
02/07/2007
Last updated
07/08/2007
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