Individual
ALICIA MARIE BOGNATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 N ABINGTON RD, CLARKS GREEN, PA 18411-2300
(570) 466-0746
Mailing address
75 LAUREL ST, CARBONDALE, PA 18407-2106
(570) 575-4583
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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