| Doctor Name: | DR. CHRISTY L BOMMARITO |
| NPI Number: | 1104816909 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 30538 |
| Business Practice Address: | 661 Justin Rd Rockwall, TX - 750874821 |
| Business Phone Number: | 9727712545 |
| Business Fax Number: | 9727710091 |
| Mailing Address: | 661 Justin Rd, ROCKWALL |
| State: | TX |
| Postal Code: | 750874821 |
| Phone Number: | 9727712545 |
| Fax Number: | 9727710091 |
| NPI Enumeration Date: | 10/24/2005 |
| NPI Last Update Date: | 03/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 30538 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |