Individual
DR. MARY JANE NIEBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
325 NEW CASTLE RD, BUTLER, PA 16001-2418
(724) 285-2501
(724) 477-5038
Mailing address
325 NEW CASTLE RD, BUTLER, PA 16001-2418
(724) 285-2501
(724) 477-5038
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS009247L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018591130001
—
PA
Enumeration date
08/09/2005
Last updated
01/05/2011
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