Doctor Name: | BONNIE BAWEL |
NPI Number: | 1609120401 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 11530 320th Ave Ne Carnation, WA - 980149792 |
Business Phone Number: | 4258444717 |
Business Fax Number: | 4258444717 |
Mailing Address: | Po Box 519, DUVALL |
State: | WA |
Postal Code: | 980190519 |
Phone Number: | 4258444516 |
Fax Number: | 4258444521 |
NPI Enumeration Date: | 10/31/2012 |
NPI Last Update Date: | 10/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |