Provider Demographics
NPI:1770949919
Name:BONIS, LAUREN NICOLE (MED)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:BONIS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MENNONITE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475
Mailing Address - Country:US
Mailing Address - Phone:610-948-6490
Mailing Address - Fax:
Practice Address - Street 1:1 MENNONITE CHURCH RD
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-1518
Practice Address - Country:US
Practice Address - Phone:610-948-6490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool