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General NPI Number Information
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NPI Number | 1225226640
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Entity Type | Organization
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Legal Business Name | B G L AND ASSOCIATES, INC.
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 107 N COURT ST SUITE 2
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City | MEDINA
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State | OH
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Zip | 44256-1934
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Country | US
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Telephone | 330-722-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 107 N COURT ST SUITE 2
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City | MEDINA
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State | OH
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Zip | 44256-1934
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Country | US
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Telephone | 330-722-9000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BERNARD G LABBE
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Credential | PCC, IMFT
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Telephone | 330-722-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F0500030
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0007664
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License Number State | OH
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