| Doctor Name: | ASHLEY ANN BONVILLAIN |
| NPI Number: | 1063753002 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC006412 |
| Business Practice Address: | 23 Eastbrook Bnd Suite 200 Peachtree City, GA - 302691565 |
| Business Phone Number: | 7704861140 |
| Business Fax Number: | 6786692693 |
| Mailing Address: | 23 Eastbrook Bnd, Suite 200 PEACHTREE CITY |
| State: | GA |
| Postal Code: | 302691565 |
| Phone Number: | 7704861140 |
| Fax Number: | 6786692693 |
| NPI Enumeration Date: | 03/14/2013 |
| NPI Last Update Date: | 04/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC006412 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |