| Doctor Name: | LYNDA BONNEAU |
| NPI Number: | 1013155035 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | CSW01226 |
| Business Practice Address: | 765 Allens Ave Suite 102 Providence, RI - 029055443 |
| Business Phone Number: | 4014908900 |
| Business Fax Number: | 4014902619 |
| Mailing Address: | 765 Allens Ave, Suite 102 PROVIDENCE |
| State: | RI |
| Postal Code: | 029055443 |
| Phone Number: | 4014908900 |
| Fax Number: | 4014902619 |
| NPI Enumeration Date: | 01/29/2009 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW01226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |