Doctor Name: | MISS COURTNEY ELAINE1989 BACH |
NPI Number: | 1891190419 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2323 Bartram Ave Atco, NJ - 080041702 |
Business Phone Number: | 8568342007 |
Business Fax Number: | |
Mailing Address: | 137 Patterson Ave, BELLMAWR |
State: | NJ |
Postal Code: | 080312129 |
Phone Number: | 8568342007 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2014 |
NPI Last Update Date: | 10/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |