Bonner, Mary

Bonner, Mary is an individual health care provider with primary practice located at 307 E Sevier St , Benton AR 72015-3934. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Bonner, Mary can be contacted via phone (501) 315-4224.

Contact Information

Primary practice address
307 E Sevier St Benton AR 72015-3934
Phone: (501) 315-4224
Fax: (501) 776-0411
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 8713P Arkansas

Profile Details

NPI number 1588651517
LBN Legal business name Bonner, Mary
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Jul 8th, 2007 - about 18 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 1588651517 NPPES
Arkansas Other 59275 BLUE CROSS BLUE SHIELD

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