DR. CARL ALBERT BONACCI PH.D.
Clinical Neuropsychologist
Phoenix, Arizona
Provider NPI: 1659488583
Provider Information:DR. CARL ALBERT BONACCI PH.D.
Gender: M
Sole Proprietor
Practice Location:
1349 E COLTER ST PHOENIX, AZ 85014 US
Tel: 928-257-4897 Fax: 866-534-1701
Business Mailing Address:
1349 E COLTER ST PHOENIX, AZ 85014 US
Tel: 928-257-4897 Fax: 866-534-1701
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | AZ | 3376 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | AZ | 3376 |
X | 103TA0700X | Behavioral Health & Social Service Providers Psychologist | AZ | 3376 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
564527 | AZ | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
CLINICAL NEUROPSYCHOLOGIST JOBS AZ - Page 1
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