Provider Demographics
NPI:1134744048
Name:FENNE, BOBBI (LMSW)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:
Last Name:FENNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8975 W NICOLET AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-1617
Mailing Address - Country:US
Mailing Address - Phone:952-220-4546
Mailing Address - Fax:
Practice Address - Street 1:4253 N CRAFTSMAN CT
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-8525
Practice Address - Country:US
Practice Address - Phone:480-702-2398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18212104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker