Provider Demographics
NPI:1255922357
Name:KRAFT, BONNIETA MELODIE (NCSP)
Entity type:Individual
Prefix:
First Name:BONNIETA
Middle Name:MELODIE
Last Name:KRAFT
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONTOOCOOK VALLEY SCHOOL DISTRICT
Mailing Address - Street 2:106 HANCOCK ROAD
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458
Mailing Address - Country:US
Mailing Address - Phone:603-563-8332
Mailing Address - Fax:
Practice Address - Street 1:CONTOOCOOK VALLEY SCHOOL DISTRICT
Practice Address - Street 2:106 HANCOCK ROAD
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458
Practice Address - Country:US
Practice Address - Phone:603-563-8332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26391103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool