Provider Demographics
NPI:1972374676
Name:HALL- BONNER, PATRICE LEONETE (EDD)
Entity Type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:LEONETE
Last Name:HALL- BONNER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 S NELLIS BLVD APT 2050
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-7706
Mailing Address - Country:US
Mailing Address - Phone:702-406-6782
Mailing Address - Fax:
Practice Address - Street 1:3055 S NELLIS BLVD APT 2050
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7706
Practice Address - Country:US
Practice Address - Phone:702-406-6782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251300000XAgenciesLocal Education Agency (LEA)
No251S00000XAgenciesCommunity/Behavioral Health