Provider Demographics
NPI:1457639635
Name:BONNE-ANNEE, TAMAR (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAMAR
Middle Name:
Last Name:BONNE-ANNEE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E WILLOW GROVE AVE
Mailing Address - Street 2:APT 605
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-4409
Mailing Address - Country:US
Mailing Address - Phone:646-651-3445
Mailing Address - Fax:718-649-0080
Practice Address - Street 1:350 E WILLOW GROVE AVE
Practice Address - Street 2:APT 605
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-4409
Practice Address - Country:US
Practice Address - Phone:646-651-3445
Practice Address - Fax:718-649-0080
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2012-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist