Basic Information
| Provider Information | |||||||||
| NPI: | 1154052538 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAHAR | ||||||||
| FirstName: | RACHEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 W 15TH ST RM B1004 | ||||||||
| Address2: | |||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190135300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106198368 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 W 15TH ST RM 1004 | ||||||||
| Address2: | |||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190135300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106198700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2022 | ||||||||
| LastUpdateDate: | 06/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Q3-0010535 | DE | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.