Provider Demographics
NPI:1952652869
Name:COMPTON, BONNIE LEE (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:LEE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CURRY DR
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-8507
Mailing Address - Country:US
Mailing Address - Phone:775-720-3054
Mailing Address - Fax:
Practice Address - Street 1:310 CAMINO DE LA PLACITA
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5951
Practice Address - Country:US
Practice Address - Phone:575-737-6115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM350408103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool