Provider Demographics
NPI:1841912532
Name:DOP, BOBBIE JO (CADC)
Entity type:Individual
Prefix:
First Name:BOBBIE JO
Middle Name:
Last Name:DOP
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CRAB ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1424
Mailing Address - Country:US
Mailing Address - Phone:803-729-0948
Mailing Address - Fax:
Practice Address - Street 1:650 N MAIN ST STE 224
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1432
Practice Address - Country:US
Practice Address - Phone:606-678-9183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)