Provider Demographics
NPI:1609013937
Name:STRICKLAND, BONNIE R (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:R
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9754
Mailing Address - Country:US
Mailing Address - Phone:413-323-5758
Mailing Address - Fax:
Practice Address - Street 1:558 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9754
Practice Address - Country:US
Practice Address - Phone:413-323-5758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1815103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical