Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1154803476 |
---|---|
Provider Name | Mrs. Janeen Bono |
First Address | Burlington, MA 01803-3642 |
Second Address | Cambridge, MA 02138-4125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 04/09/2018 |