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General NPI Number Information
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NPI Number | 1982479168
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Entity Type | Organization
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Legal Business Name | BOBBI L PETRANCHUK LCSW PLLC
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 8383 S MAIN ST
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City | EVANS MILLS
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State | NY
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Zip | 13637-3200
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Country | US
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Telephone | 585-867-0054
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Fax | 855-485-1189
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Provider Business Mailing Address
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Address Line | 8290 NUMBER 2 RD E
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City | MANLIUS
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State | NY
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Zip | 13104-8795
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Country | US
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Telephone | 585-867-0054
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Fax | 855-485-1189
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Authorized Official
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Title or Position | OWNER
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Name | BOBBI PETRANCHUK
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Credential | LCSW-R
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Telephone | 315-681-7087
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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 |
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License Number State |
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