Individual
KATHLEEN L PETULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5000 MCKNIGHT RD STE 202, PITTSBURGH, PA 15237-3420
(412) 366-8342
Mailing address
1012 CIDER MILL DR, GIBSONIA, PA 15044-9284
(412) 889-2333
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW014722
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1434077
HIGHMARK
PA
01
—
493578000
MAGELLAN
PA
Enumeration date
04/26/2006
Last updated
07/07/2023
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