Doctor Name: | DR. JONETTE ROSELLE BRONSON |
NPI Number: | 1023196235 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1318 |
Business Practice Address: | 560 Mountain Village Blvd Suite #101 Telluride, CO - 814359513 |
Business Phone Number: | 9707280504 |
Business Fax Number: | |
Mailing Address: | 560 Mountain Village Blvd, Suite #101 TELLURIDE |
State: | CO |
Postal Code: | 814359513 |
Phone Number: | 9707280504 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |