Healthcare Provider Details

I. General information

NPI: 1548563018
Provider Name (Legal Business Name): MISS ROZA SARGSYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 BARRETT DR
BETHLEHEM PA
18017-2765
US

IV. Provider business mailing address

1741 BARRETT DR
BETHLEHEM PA
18017-2765
US

V. Phone/Fax

Practice location:
  • Phone: 610-440-4053
  • Fax:
Mailing address:
  • Phone: 610-440-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC020427
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: