Provider Demographics
NPI:1477604940
Name:SIEGEL, BOBETTE (MSW)
Entity Type:Individual
Prefix:
First Name:BOBETTE
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8847
Mailing Address - Country:US
Mailing Address - Phone:480-948-6222
Mailing Address - Fax:480-219-9970
Practice Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-948-6222
Practice Address - Fax:480-219-9970
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ109011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z115286Medicare PIN