Provider Demographics
NPI:1063820348
Name:BONAPARTE, TARIA (MA)
Entity Type:Individual
Prefix:
First Name:TARIA
Middle Name:
Last Name:BONAPARTE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S BRIGHTLEAF BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4077
Mailing Address - Country:US
Mailing Address - Phone:919-727-8090
Mailing Address - Fax:
Practice Address - Street 1:201 S BRIGHTLEAF BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4077
Practice Address - Country:US
Practice Address - Phone:919-727-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10801101YP2500X
NCA10801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional