Doctor Name: | BONNIE ANN DEN DOOVEN |
NPI Number: | 1073977070 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MC, LPC, CSAT |
License Number: | LPC-15443 |
Business Practice Address: | 15331 W Bell Rd Ste 212 Surprise, AZ - 853744104 |
Business Phone Number: | 9282312411 |
Business Fax Number: | 9282312411 |
Mailing Address: | 50825 N 328th Ave, WICKENBURG |
State: | AZ |
Postal Code: | 853903107 |
Phone Number: | 9282312411 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2016 |
NPI Last Update Date: | 04/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC-15443 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |