Individual
BONNIE L GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., M.A.
Contact information
Practice address
452 S FRANKLIN ST, TITUSVILLE, PA 16354-2246
(814) 827-6648
(814) 827-0206
Mailing address
452 S FRANKLIN ST, TITUSVILLE, PA 16354-2246
(814) 827-6648
(814) 827-0206
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC009990
PA
231H00000X
Audiologist
Primary
AT000179-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01651983
—
PA
Enumeration date
11/16/2006
Last updated
11/07/2017
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