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General NPI Number Information
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NPI Number | 1295058402
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Entity Type | Individual
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Provider Name | JENNIFER CANDACE BONNER MS
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Gender | Female
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 107 W 5TH NORTH ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6446
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Country | US
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Telephone | 843-871-9669
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 ROLAND CLARKE PL APT 109
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City | RESTON
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State | VA
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Zip | 20191-1453
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Country | US
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Telephone | 843-566-2570
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201002074
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3922
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License Number State | SC
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