Healthcare Provider Details

I. General information

NPI: 1467736272
Provider Name (Legal Business Name): LYNN M OBORSKI M.S., NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 STATE ST
ERIE PA
16508-1832
US

IV. Provider business mailing address

2622 BIRD DR
ERIE PA
16510-2720
US

V. Phone/Fax

Practice location:
  • Phone: 814-878-3431
  • Fax:
Mailing address:
  • Phone: 814-881-7105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006041
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: