MEDICARE: JANELLA DOBBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1679941488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANELLA DOBBS

Provider Business Mailing Address
First Line	:	1662 WAKELING ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-2754
Country	:	US
Telephone Number	:	267-230-8723
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-2651
Country	:	US
Telephone Number	:	267-230-8723
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2015
Last Update Date	:	09/10/2015

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Directions to “ JANELLA DOBBS ” Practice Location

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