Provider Demographics
NPI:1679282735
Name:BONNELL, MARIA E
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:E
Last Name:BONNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36947 COOK ST STE 104
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6078
Mailing Address - Country:US
Mailing Address - Phone:760-614-2373
Mailing Address - Fax:
Practice Address - Street 1:36947 COOK ST STE 104
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6078
Practice Address - Country:US
Practice Address - Phone:760-614-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician