Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | PSY 002463 | GA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY 002463 | GA |
Y | 103G00000X | Clinical Psychologist | 1405 | SC |
Y | 103TC0700X | Clinical Psychologist | 1405 | SC |
N | 103G00000X | Clinical Psychologist | PSY 002463 | GA |
N | 103TC0700X | Clinical Psychologist | PSY 002463 | GA |
N | 103TC1900X | Counseling Psychologist | PSY 002463 | GA |
N | 103TH0004X | Health Psychologist | 1405 | SC |
N | 103TP0814X | Psychoanalysis | PSY 002463 | GA |
N | 103TP2701X | Group Psychotherapist | PSY 002463 | GA |
NPI | 1073753653 |
---|---|
Provider Name | Dr. Bonnie L Kessler |
First Address | Greenville, SC 29615-6079 |
Second Address | Greenville, SC 29607-2868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2009 |
Last Update Date | 04/06/2020 |