Provider Demographics
NPI:1467601013
Name:ZON, BONNIE JEAN
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:JEAN
Last Name:ZON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BONNIE
Other - Middle Name:JEAN
Other - Last Name:LICURSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 CULPEPPER RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3655
Mailing Address - Country:US
Mailing Address - Phone:716-632-0137
Mailing Address - Fax:
Practice Address - Street 1:222 CULPEPPER RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3655
Practice Address - Country:US
Practice Address - Phone:716-632-0137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0097121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist