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NPI Code Detail

MEDICARE: JOSEPH DANTE BOMMARITO PROFESSIONAL COUNSEL

MEDICARE: JOSEPH DANTE BOMMARITO PROFESSIONAL COUNSEL
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
1101YP2500XProfessional Counselor6401010326MI
2101Y00000XCounselor6401010326MI

General Provider Information

NPI Number : 1275704777
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH DANTE BOMMARITO PROFESSIONAL COUNSEL
Provider Business Mailing Address
First Line : 13001 23 MILE RD STE 103
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-2767
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13001 23 MILE RD STE 103
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-2767
Country : US
Telephone Number : 800-693-1916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2008
Last Update Date : 05/06/2019

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Directions to “ JOSEPH DANTE BOMMARITO PROFESSIONAL COUNSEL” Practice Location

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