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General NPI Number Information
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NPI Number | 1386418267
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Entity Type | Organization
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Legal Business Name | BONNIE E. O'BRIEN, LCSW, PLLC
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 411 MAIN ST REAR
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City | EAST AURORA
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State | NY
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Zip | 14052-1700
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Country | US
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Telephone | 716-235-1519
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Fax |
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Provider Business Mailing Address
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Address Line | 411 MAIN ST REAR
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City | EAST AURORA
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State | NY
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Zip | 14052-1700
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Country | US
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Telephone | 716-235-1519
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BONNIE ELIZABETH O'BRIEN
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Credential | LCSW
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Telephone | 716-200-8873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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