Provider Demographics
NPI:1821390782
Name:ZOPPETTI, BERNADETTE M (PCC)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:M
Last Name:ZOPPETTI
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8976
Mailing Address - Country:US
Mailing Address - Phone:570-387-1832
Mailing Address - Fax:
Practice Address - Street 1:816 CENTRAL RD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8976
Practice Address - Country:US
Practice Address - Phone:570-387-1832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009011101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor