Provider Demographics
NPI:1407282338
Name:BUCCO, BONNIE WINN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:WINN
Last Name:BUCCO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2871 INVERNESS CT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-5030
Mailing Address - Country:US
Mailing Address - Phone:850-485-0932
Mailing Address - Fax:850-434-3150
Practice Address - Street 1:2871 INVERNESS CT
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-5030
Practice Address - Country:US
Practice Address - Phone:850-485-0932
Practice Address - Fax:850-434-3150
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health