Doctor Name: | JENNA MAHAR BONVELL |
NPI Number: | 1619125945 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,CCC- SLP |
License Number: | 018280 |
Business Practice Address: | 143 N Pearl St Canandaigua, NY - 144241430 |
Business Phone Number: | 5857645578 |
Business Fax Number: | |
Mailing Address: | 73 Maple Valley Cres, ROCHESTER |
State: | NY |
Postal Code: | 146235209 |
Phone Number: | 5857645578 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 09/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 018280 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |