Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2163 | MA |
Y | 103TC0700X | Clinical Psychologist | 2163 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2163 | MA |
N | 103TP0814X | Psychoanalysis | 2163 | MA |
NPI | 1023433034 |
---|---|
Provider Name | Dr. Rona Bonnie Knight |
First Address | Chestnut Hill, MA 02467 |
Second Address | Chestnut Hill, MA 02467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2014 |
Last Update Date | 28/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2163 | MA PSYCHOLOGY LICENSE (01) | MA |