Provider Demographics
NPI:1033670765
Name:BONSU, SANDRA TWUMASI (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:TWUMASI
Last Name:BONSU
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 CROMWELL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3318
Mailing Address - Country:US
Mailing Address - Phone:410-583-1515
Mailing Address - Fax:
Practice Address - Street 1:1026 CROMWELL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-3318
Practice Address - Country:US
Practice Address - Phone:410-583-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician