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NPI Code Detail

MEDICARE: BRUCE WARD RAPPAPORT M.DIV., M.ED., NCC

MEDICARE: BRUCE WARD RAPPAPORT M.DIV., M.ED., NCC
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
1101YM0800XMental Health CounselorPC-0000378DE
2101YP2500XProfessional CounselorPC-0000378DE

General Provider Information

NPI Number : 1871793463
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE WARD RAPPAPORT M.DIV., M.ED., NCC
Provider Business Mailing Address
First Line : 20 MAN O WAR DR
Second Line :
City : MEDIA
State : PA
Zip : 19063-5215
Country : US
Telephone Number : 610-565-1936
Fax Number :
Provider Business Practice Location Address
First Line : 5235 W WOODMILL DR
Second Line : SUITES 47 & 48
City : WILMINGTON
State : DE
Zip : 19808-4068
Country : US
Telephone Number : 302-995-1680
Fax Number : 302-995-1790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2007
Last Update Date : 07/20/2007

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