Provider Demographics
NPI:1134740954
Name:ANDREWS, BONNIE (MPH, PHD)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MASSASOIT RD
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1651
Mailing Address - Country:US
Mailing Address - Phone:627-823-3177
Mailing Address - Fax:
Practice Address - Street 1:185 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1407
Practice Address - Country:US
Practice Address - Phone:617-259-1895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11289103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical