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Organization

ELIZABETH WALLACH MA PSYCHOLOGIST

Active
Parent organization
ELIZABETH WALLACH MA PSYCHOLOGIST
Organization subpart
Yes

Provider details

NPI number
Legal business name
ELIZABETH WALLACH MA PSYCHOLOGIST
Authorized official
ELIZABETH WALLACH MA (PSYCHOLOGIST)
(724) 413-4991
Entity
Organization

Contact information

Practice address
2809 OLD WASHINGTON RD, MCMURRAY, PA 15317
(724) 413-4991
(724) 941-2595
Mailing address
2809 OLD WASHINGTON RD, MCMURRAY, PA 15317
(724) 413-4991
(724) 941-2595

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PS6340L
PA
103T00000X
Psychologist
Primary
PS6340L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015239920001
PA
Enumeration date
03/26/2008
Last updated
03/26/2008
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