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BONNIE SLADE PH.D.

Clinical Neuropsychologist

Palm Bay, Florida

Provider NPI: 1477552743

Provider Information:
 BONNIE  SLADE PH.D.
Gender: F
Sole Proprietor


Practice Location:
1555 PORT MALABAR BLVD NE SUITE 104 PALM BAY, FL 32905 US
Tel: 321-729-0870  Fax: 321-952-2516

Business Mailing Address:
1555 PORT MALABAR BLVD NE SUITE 104 PALM BAY, FL 32905 US
Tel: 321-729-0870  Fax: 321-952-2516

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
FLPY002036
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
FLPY002036
X103TC2200XBehavioral Health & Social Service Providers
Psychologist
FLPY002036
X103TF0000XBehavioral Health & Social Service Providers
Psychologist
FLPY002036
X103TM1800XBehavioral Health & Social Service Providers
Psychologist
FLPY002036
X103T00000XBehavioral Health & Social Service Providers
Psychologist
FLPY002036
X103TB0200XBehavioral Health & Social Service Providers
Psychologist
FLPY002036
X103TH0100XBehavioral Health & Social Service Providers
Psychologist
FLPY002036

Other Provider Identifiers:

IssuerNumberStateType
BCBS PROVIDER ID73246FL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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