Provider Demographics
NPI:1407462278
Name:STINSON, BONNIE B (MS)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:B
Last Name:STINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO FALLS
Mailing Address - State:NH
Mailing Address - Zip Code:03896-0190
Mailing Address - Country:US
Mailing Address - Phone:603-569-5167
Mailing Address - Fax:603-569-6983
Practice Address - Street 1:404 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4415
Practice Address - Country:US
Practice Address - Phone:603-569-5167
Practice Address - Fax:603-569-3689
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH42395103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool