Provider Demographics
NPI:1073969937
Name:SOBON, KATELYN MICHELLE (MED)
Entity Type:Individual
Prefix:MISS
First Name:KATELYN
Middle Name:MICHELLE
Last Name:SOBON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MUSTANG WAY
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4312
Mailing Address - Country:US
Mailing Address - Phone:215-520-2515
Mailing Address - Fax:
Practice Address - Street 1:134 MUSTANG WAY
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-4312
Practice Address - Country:US
Practice Address - Phone:215-520-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor