Doctor Name: | DR. BONNIE LOUISE MACDONALD |
NPI Number: | 1376751297 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 6405 |
Business Practice Address: | 40 South St Suite 201 Marblehead, MA - 019453282 |
Business Phone Number: | 6178381924 |
Business Fax Number: | 7816316382 |
Mailing Address: | 2 Buena Vista Rd, MARBLEHEAD |
State: | MA |
Postal Code: | 019451328 |
Phone Number: | 6178381924 |
Fax Number: | 7816316382 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TB0200X |
License Number: | 6405 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Cognitive & Behavioral |
Taxonomy Definition: |