Provider Demographics
NPI:1689726853
Name:GUEST, BONNIE GRACE (MFT)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:GRACE
Last Name:GUEST
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:BONNIE
Other - Middle Name:GRACE
Other - Last Name:SARAKBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:3415 E COCHISE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028
Mailing Address - Country:US
Mailing Address - Phone:602-485-5700
Mailing Address - Fax:
Practice Address - Street 1:8687 E VIA DE VENTUA
Practice Address - Street 2:SUITE #113
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-998-2303
Practice Address - Fax:480-998-3169
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT0396106H00000X
NYLMFT0000371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist