Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | GA |
NPI | 1013582337 |
---|---|
Provider Name | Densua Yalantys Bonner |
First Address | East Point, GA 30344-5340 |
Second Address | Lithonia, GA 30058-1105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2021 |
Last Update Date | 20/05/2021 |