| Doctor Name: | BONITA L ROBERTS |
| NPI Number: | 1013172550 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PCC |
| License Number: | E0005120 |
| Business Practice Address: | 2150 W Central Ave Toledo, OH - 436063846 |
| Business Phone Number: | 4192917919 |
| Business Fax Number: | 4194793273 |
| Mailing Address: | 7140 Port Sylvania Dr, #600 TOLEDO |
| State: | OH |
| Postal Code: | 436171176 |
| Phone Number: | 4198438178 |
| Fax Number: | 4198438698 |
| NPI Enumeration Date: | 07/24/2008 |
| NPI Last Update Date: | 07/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | E0005120 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |