Provider Demographics
NPI:1912906652
Name:SCHWENDER, BONNIE (MS, MA)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:SCHWENDER
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CEDAR PLAZA PARKWAY
Mailing Address - Street 2:STE 350
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3441
Mailing Address - Country:US
Mailing Address - Phone:314-843-4333
Mailing Address - Fax:314-843-4856
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:SUITE 221
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-3900
Practice Address - Country:US
Practice Address - Phone:314-892-0667
Practice Address - Fax:314-892-0921
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist