Provider Demographics
NPI:1770679169
Name:BOBOWICZ, WILLIAM JOHN JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:BOBOWICZ
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:23210 CHAGRIN BLVD
Mailing Address - Street 2:SUITE #400
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5429
Mailing Address - Country:US
Mailing Address - Phone:216-831-6466
Mailing Address - Fax:216-766-6083
Practice Address - Street 1:23210 CHAGRIN BLVD
Practice Address - Street 2:SUITE #400
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5429
Practice Address - Country:US
Practice Address - Phone:216-831-6466
Practice Address - Fax:216-766-6083
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6223103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical