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NPI Code Detail

MEDICARE: BONNIE JOYCE SAMPSON

MEDICARE: BONNIE JOYCE SAMPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorPA

General Provider Information

NPI Number : 1023055662
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE JOYCE SAMPSON
Provider Business Mailing Address
First Line : 331 SHAW AVE
Second Line :
City : MCKEESPORT
State : PA
Zip : 15132-2918
Country : US
Telephone Number : 412-675-8501
Fax Number :
Provider Business Practice Location Address
First Line : 331 SHAW AVE
Second Line :
City : MCKEESPORT
State : PA
Zip : 15132-2918
Country : US
Telephone Number : 412-675-8501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 07/08/2007

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Directions to “ BONNIE JOYCE SAMPSON ” Practice Location

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