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General NPI Number Information
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NPI Number | 1790221562
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Entity Type | Individual
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Provider Name | BONNIE RICARD
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Gender | Female
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 1386 OLD FREEPORT RD 1AF
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City | PITTSBURGH
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State | PA
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Zip | 15238-3115
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Country | US
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Telephone | 412-406-7052
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Fax | 412-406-7139
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Provider Business Mailing Address
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Address Line | 170 JAMISON LN SUITE 1
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City | MONROEVILLE
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State | PA
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Zip | 15146-2327
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Country | US
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Telephone |
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC002539
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License Number State | PA
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