Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 008011 | PA |
NPI | 1003201153 |
---|---|
Provider Name | Emilie Bobrow |
First Address | Eagleville, PA 19403-1408 |
Second Address | Eagleville, PA 19403-1408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2015 |
Last Update Date | 04/04/2015 |