Provider Demographics
NPI:1588762090
Name:RIGATTI DRUM, CAROL R (MS)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:R
Last Name:RIGATTI DRUM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 VALLEYBROOK RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3428
Mailing Address - Country:US
Mailing Address - Phone:724-941-8824
Mailing Address - Fax:724-942-4540
Practice Address - Street 1:501 VALLEYBROOK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3428
Practice Address - Country:US
Practice Address - Phone:724-941-8824
Practice Address - Fax:724-942-4540
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007713-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5165436OtherAETNA ID