Provider Demographics
NPI:1851517833
Name:BARTOL, BONNIE JEAN (MA NCSP)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:JEAN
Last Name:BARTOL
Suffix:
Gender:F
Credentials:MA NCSP
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:BARTOL
Other - Last Name:SCHAIBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1210 W TULANE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
Mailing Address - Country:US
Mailing Address - Phone:480-820-3097
Mailing Address - Fax:
Practice Address - Street 1:705 S 32ND ST
Practice Address - Street 2:MESA PUBLIC SCHOOLS TAYLOR JR HIGH
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204
Practice Address - Country:US
Practice Address - Phone:480-472-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool