Provider Demographics
NPI:1518774645
Name:WISSINGER, NOAH (RBT)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:WISSINGER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 PERRY HWY BLDG 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-2220
Mailing Address - Country:US
Mailing Address - Phone:412-295-6734
Mailing Address - Fax:412-837-1290
Practice Address - Street 1:4900 PERRY HWY BLDG 2
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229-2220
Practice Address - Country:US
Practice Address - Phone:412-295-6734
Practice Address - Fax:412-837-1290
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARBT-24-387696106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician