Individual
MS. ELIZABETH WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1061 WATERDAM PLAZA DR STE 208, CANONSBURG, PA 15317-5408
(724) 413-4991
(724) 260-0221
Mailing address
1061 WATERDAM PLAZA DR STE 208, CANONSBURG, PA 15317-5408
(724) 413-4991
(724) 260-0221
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS6340L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001523992001
—
PA
Enumeration date
03/26/2007
Last updated
02/10/2023
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