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General NPI Number Information
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NPI Number | 1467722660
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Entity Type | Organization
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Legal Business Name | BONDS, MATHIS AND ASSOCIATES INC
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 109 WHITE ALLEN AVE
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City | DAYTON
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State | OH
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Zip | 45405-4932
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Country | US
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Telephone | 937-277-7962
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Fax | 937-277-6067
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Provider Business Mailing Address
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Address Line | 529 W GRAND AVE
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City | DAYTON
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State | OH
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Zip | 45405-4408
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Country | US
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Telephone | 937-277-7962
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Fax | 937-277-6067
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GIOVANNI OLIVIA BONDS
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Credential | PHD
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Telephone | 937-277-7962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3055
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License Number State | OH
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