Individual
MS. THERESA M BOBBITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
2976 NORTHERN BLVD, LONG ISLAND CITY, NY 11101-2822
(212) 691-7554
(347) 510-3455
Mailing address
1683 UNIVERSITY AVE APT 4D, BRONX, NY 10453-6910
(718) 517-7934
(347) 510-3455
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21424
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21424
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
NY
Enumeration date
02/20/2014
Last updated
02/20/2014
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