Provider Demographics
NPI:1619980190
Name:MCLAUGHLIN, BONNIE BEA (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:BEA
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41765 12TH ST W
Mailing Address - Street 2:SUITE D
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1422
Mailing Address - Country:US
Mailing Address - Phone:661-940-4861
Mailing Address - Fax:661-942-4511
Practice Address - Street 1:41765 12TH ST W
Practice Address - Street 2:SUITE D
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1422
Practice Address - Country:US
Practice Address - Phone:661-940-4861
Practice Address - Fax:661-942-4511
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT31478106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist