Provider Demographics
NPI:1710389408
Name:BONNELL, MELISSA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:BONNELL
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 1:50 S STEELE ST STE 950
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4337
Mailing Address - Country:US
Mailing Address - Phone:303-304-6690
Mailing Address - Fax:720-764-0266
Practice Address - Street 1:50 S STEELE ST STE 950
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2843
Practice Address - Country:US
Practice Address - Phone:303-304-6690
Practice Address - Fax:720-764-0266
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1374103TC1900X
CO4991103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling