Individual
DR. BRUCE DANIEL KOBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3939 W RIDGE RD # B47, ERIE, PA 16506-1879
(814) 923-8140
(814) 315-6044
Mailing address
3939 W RIDGE RD # B47, ERIE, PA 16506-1879
(814) 923-8410
(814) 315-6044
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS006269L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000505965
HIMARK BC/BS
PA
01
—
114436
VALUEOPTIONS
PA
Enumeration date
09/21/2006
Last updated
04/28/2023
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