Dr. Georgia Dare Bomgardner, PhD
Psychologist in Bethlehem, PA. Individual provider (NPI-1).
NPI number1568071785
StatusActive
Last updated in NPPESJul 23, 2020
Details
- NPI
- 1568071785
- Entity type
- Individual (NPI-1)
- Name
- Dr. Georgia Dare Bomgardner
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 23, 2020
- Certification date
- Jul 23, 2020
- Last updated
- Jul 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PS019058 | PA | Yes |
Practice location
1 E Broad St Ste 510Bethlehem, PA 18018-5964
Phone 610-865-4300
Mailing address
793 E Washington AveBethlehem, PA 18017-6043
Phone 901-230-2919
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