Basic Information
| Provider Information | |||||||||
| NPI: | 1194477927 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ENGLER | ||||||||
| FirstName: | BOBBIE | ||||||||
| MiddleName: | JO | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PEER SUPPORT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 EWING CT APT 11 | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | KY | ||||||||
| PostalCode: | 406012681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029567223 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 140 KINGS DAUGHTERS DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | KY | ||||||||
| PostalCode: | 406014242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026992885 | ||||||||
| FaxNumber: | 5026992890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2022 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175T00000X | 1203542 | KY | Y |
No ID Information.