Doctor Name: | MR. TRINITY C BONNER |
NPI Number: | 1326350133 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | S2188 |
Business Practice Address: | 408 Owen Dr Hattiesburg, MS - 394021854 |
Business Phone Number: | 6014104122 |
Business Fax Number: | |
Mailing Address: | 408 Owen Dr, HATTIESBURG |
State: | MS |
Postal Code: | 394021854 |
Phone Number: | 6014104122 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2010 |
NPI Last Update Date: | 05/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S2188 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |