Healthcare Provider Details
I. General information
NPI: 1942409206
Provider Name (Legal Business Name): ELEANOR RICHMAN BOBROW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2956 WASHINGTON ST
EASTON PA
18045-2562
US
IV. Provider business mailing address
175 S 21ST ST
EASTON PA
18042-3835
US
V. Phone/Fax
- Phone: 610-258-1161
- Fax: 610-258-1161
- Phone: 610-559-8151
- Fax: 610-559-9056
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | CW014198 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: