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General NPI Number Information
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NPI Number | 1730161266
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Entity Type | Individual
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Provider Name | PATRICIA BRUCE LCSW, DCSW
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4402 PEACH ST SUITE 2A
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City | ERIE
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State | PA
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Zip | 16509-1358
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Country | US
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Telephone | 814-860-8800
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Fax | 814-860-8800
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Provider Business Mailing Address
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Address Line | 4402 PEACH ST SUITE 2A
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City | ERIE
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State | PA
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Zip | 16509-1358
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Country | US
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Telephone | 814-860-8800
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Fax | 814-860-8800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW 014600
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License Number State | PA
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