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Organization

BONNIE GROSS, MA, LPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BONNIE L GROSS MA, LPC (PROFESSIONAL COUNSELOR)
(814) 827-6648
Entity
Organization

Contact information

Practice address
452 S FRANKLIN ST STE B, TITUSVILLE, PA 16354-2246
(814) 827-6648
(814) 707-3056
Mailing address
452 S FRANKLIN ST STE B, TITUSVILLE, PA 16354-2246
(814) 827-6648
(814) 707-3056

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016519830008
PA
01
003722233
HIGHMARK
PA
Enumeration date
10/24/2018
Last updated
07/24/2019
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