Provider Demographics
NPI:1649043159
Name:BOVENDER, WILLIAM PERRY (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PERRY
Last Name:BOVENDER
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 ORLEANS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-2293
Mailing Address - Country:US
Mailing Address - Phone:828-289-6270
Mailing Address - Fax:
Practice Address - Street 1:1618 ORLEANS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-2293
Practice Address - Country:US
Practice Address - Phone:828-289-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6321103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist