Mary Bonner is a Psychologist in Benton, Arkansas. Mary Bonner practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Mary Bonner is 1588651517. The last update date is 2007-07-08.
Mary Bonner's current location address is 307 E Sevier St, Benton, Arkansas. You can contact this provider via phone number 5013154224 and fax number 5017760411. The mailing address for Mary Bonner is 307 E Sevier St, Benton, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Bonner |
|---|---|
| Address | 307 E Sevier St, Benton, Arkansas |
| Phone Number | 5013154224 |
| Fax Number | 5017760411 |
| Sole Proprietor | X |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1588651517 |
|---|---|
| Provider Enumeration Date | 2005-10-04 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 307 E Sevier St |
|---|---|
| City | Benton |
| State | Arkansas (AR) |
| Post Code | 720153934 |
| Phone Number | 5013154224 |
| Fax Number | 5017760411 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 8713P |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 59275 | AR | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique provider identifier assigned to Mary Bonner?
The Mary Bonner has been issued the NPI (National Provider Identifier) 1588651517 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where Mary Bonner is located?
The Mary Bonner is situated at the following address: 307 E Sevier St, Benton, AR, 720153934.
What is Mary Bonner's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Bonner's area of specialization is Psychologist, and the corresponding taxonomy code that categorizes this field of practice is 103T00000X.
On what date did the Mary Bonner receive its 1588651517 assignment from the Centers for Medicare & Medicaid Services?
The Mary Bonner was assigned its 1588651517 by the Centers for Medicare & Medicaid Services on 2005-10-04.
As of what date were the Mary Bonner's details last updated?
The information pertaining to the Mary Bonner, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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