Provider Demographics
NPI:1538164256
Name:BONDS, GIOVANNI M (PHD)
Entity type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:M
Last Name:BONDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4408
Mailing Address - Country:US
Mailing Address - Phone:937-277-7962
Mailing Address - Fax:937-277-6067
Practice Address - Street 1:109 WHITE ALLEN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4932
Practice Address - Country:US
Practice Address - Phone:937-277-7962
Practice Address - Fax:937-277-6067
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3055103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0474526Medicaid
OH0474526Medicaid