Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1342 | CO |
NPI | 1104038561 |
---|---|
Provider Name | Dr. Bonnie J Messer |
First Address | Centennial, CO 80112-1263 |
Second Address | Centennial, CO 80112-1263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2007 |
Last Update Date | 02/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070113428 | (05) | CO |