Doctor Name: | DR. THERESA ANN KOVACS |
NPI Number: | 1427383223 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PS016798 |
Business Practice Address: | 340 Montage Mountain Rd Moosic, PA - 185071782 |
Business Phone Number: | 5703463686 |
Business Fax Number: | 5705586838 |
Mailing Address: | 340 Montage Mountain Rd, MOOSIC |
State: | PA |
Postal Code: | 185071782 |
Phone Number: | 5703463686 |
Fax Number: | 5705586838 |
NPI Enumeration Date: | 10/12/2009 |
NPI Last Update Date: | 09/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS016798 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |