Individual
JESSICA RUSBATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1622 LOCUST ST FL 4, PITTSBURGH, PA 15219-5924
(412) 232-8901
Mailing address
4310 LONDONDERRY RD STE 202, HARRISBURG, PA 17109-5329
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0810006229
VA
103G00000X
Clinical Neuropsychologist
PS019043
PA
103T00000X
Psychologist
Primary
PS019043
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103783204
—
PA
01
—
1E5823
MEDICARE
PA
Enumeration date
05/26/2020
Last updated
02/01/2024
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