Doctor Name: | MRS. BOBBI-JO GROSS-ZELL |
NPI Number: | 1356637862 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC2030 |
Business Practice Address: | 101 Colonial Way Suite A Rising Sun, MD - 219112272 |
Business Phone Number: | 4439078245 |
Business Fax Number: | |
Mailing Address: | 32 Naylor Blue Ct, PORT DEPOSIT |
State: | MD |
Postal Code: | 219041230 |
Phone Number: | 4439078245 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2011 |
NPI Last Update Date: | 09/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC2030 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |