Provider Demographics
NPI:1235432816
Name:PERRY, BONITA SALTER (EDS)
Entity Type:Individual
Prefix:
First Name:BONITA
Middle Name:SALTER
Last Name:PERRY
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 S GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-2537
Mailing Address - Country:US
Mailing Address - Phone:251-232-0419
Mailing Address - Fax:251-434-6644
Practice Address - Street 1:1250 POYDRAS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1804
Practice Address - Country:US
Practice Address - Phone:504-619-4567
Practice Address - Fax:504-252-4682
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor