Provider Demographics
NPI:1285782391
Name:PETERSON-HANDLEY, CYNTHIA ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:PETERSON-HANDLEY
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 1:4047 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668
Mailing Address - Country:US
Mailing Address - Phone:724-327-8306
Mailing Address - Fax:724-325-3408
Practice Address - Street 1:4047 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1846
Practice Address - Country:US
Practice Address - Phone:412-389-5043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 007661-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01824762Medicaid
PA654605OtherMEDICARE PTAN
PAR98285Medicare UPIN