Bonacci, Carl Albert

Bonacci, Carl Albert is an sole proprietor health care provider with primary practice located at 1349 E Colter St , Phoenix AZ 85014-3048. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Bonacci, Carl Albert can be contacted via phone (928) 257-4897.

Contact Information

Primary practice address
1349 E Colter St Phoenix AZ 85014-3048
Phone: (928) 257-4897
Fax: (866) 534-1701
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 3376 Arizona
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3376 Arizona
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 3376 Arizona

Profile Details

NPI number 1659488583
LBN Legal business name Bonacci, Carl Albert
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659488583 NPPES
Arizona MEDICAID 564527

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