Provider Demographics
NPI:1104038561
Name:MESSER, BONNIE J (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:J
Last Name:MESSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 E ARAPAHOE RD
Mailing Address - Street 2:STE 305
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1263
Mailing Address - Country:US
Mailing Address - Phone:303-770-1540
Mailing Address - Fax:
Practice Address - Street 1:7600 E ARAPAHOE RD
Practice Address - Street 2:STE 305
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1263
Practice Address - Country:US
Practice Address - Phone:303-770-1540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1342103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO070113428Medicaid