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General NPI Number Information
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NPI Number | 1356986319
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Entity Type | Organization
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Legal Business Name | THREE DIRTY BIRDS LLC
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 805 LORRAINE DR
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City | SPRINGFIELD
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State | PA
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Zip | 19064-1004
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Country | US
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Telephone | 610-543-4048
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 330
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City | SWARTHMORE
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State | PA
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Zip | 19081-0330
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Country | US
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Telephone | 610-543-4048
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Fax |
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Authorized Official
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Title or Position | PARTNER OWNER
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Name | MR. PETER J. BENDIG JR.
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Credential | PHD/ABD, LPC
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Telephone | 610-543-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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