Provider Demographics
NPI:1578611034
Name:ROBINSON, BONNIE (PSYD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:R
Other - Last Name:CIMRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:675 MORRIS AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1525
Mailing Address - Country:US
Mailing Address - Phone:973-218-1176
Mailing Address - Fax:
Practice Address - Street 1:675 MORRIS AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1525
Practice Address - Country:US
Practice Address - Phone:973-218-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI3688103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist