Individual
CAROLE JEANNE WEIDAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
110 FORT COUCH RD, SUITE G-200, PITTSBURGH, PA 15241-1030
(412) 347-0170
(412) 347-0174
Mailing address
110 FORT COUCH RD, SUITE G-200, PITTSBURGH, PA 15241-1030
(412) 347-0170
(412) 347-0174
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005916L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
699063
HIGHMARK BCBS
PA
05
—
705999501
—
PA
Enumeration date
04/28/2006
Last updated
09/12/2011
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