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General NPI Number Information
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NPI Number | 1013582337
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Entity Type | Individual
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Provider Name | DENSUA YALANTYS BONNER
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Gender | Female
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 3035 STONE MOUNTAIN ST UNIT 520
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City | LITHONIA
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State | GA
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Zip | 30058-1105
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Country | US
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Telephone | 470-344-9289
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Fax |
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Provider Business Mailing Address
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Address Line | 3260 DODSON DR CONNECTOR APT 7
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City | EAST POINT
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State | GA
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Zip | 30344-5340
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Country | US
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Telephone | 478-390-5179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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