Provider Demographics
NPI:1558491290
Name:WARREN, BONNIE HOBBS (MA,EDS, CCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:HOBBS
Last Name:WARREN
Suffix:
Gender:F
Credentials:MA,EDS, 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:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:NEWTON GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28366-0481
Mailing Address - Country:US
Mailing Address - Phone:910-990-1010
Mailing Address - Fax:910-594-1799
Practice Address - Street 1:270 BRITT RD.
Practice Address - Street 2:
Practice Address - City:NEWTON GROVE
Practice Address - State:NC
Practice Address - Zip Code:28366
Practice Address - Country:US
Practice Address - Phone:910-990-1010
Practice Address - Fax:910-594-1799
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412156Medicaid