Provider Demographics
NPI:1154608388
Name:DALLESASSE, STARLA LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:STARLA
Middle Name:LEE
Last Name:DALLESASSE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 GREENTREE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3508
Mailing Address - Country:US
Mailing Address - Phone:412-822-2972
Mailing Address - Fax:
Practice Address - Street 1:875 GREENTREE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3508
Practice Address - Country:US
Practice Address - Phone:412-822-2972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1759103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling