Provider Demographics
NPI:1801764527
Name:BODAI MUSSELMAN, AUBREY (LSW)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:BODAI MUSSELMAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-1825
Mailing Address - Country:US
Mailing Address - Phone:610-799-8910
Mailing Address - Fax:
Practice Address - Street 1:801 E GREEN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-1825
Practice Address - Country:US
Practice Address - Phone:610-799-8910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW143153104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty