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General NPI Number Information
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NPI Number | 1659045870
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Entity Type | Individual
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Provider Name | JORDAN ELIZABETH BONNER MA NCC CATP CCTP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 113 ALWINE AVE
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City | GREENSBURG
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State | PA
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Zip | 15601-3209
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Country | US
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Telephone | 412-610-9107
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Fax |
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Provider Business Mailing Address
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Address Line | 1277 6TH ST
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City | WESTMORELAND CITY
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State | PA
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Zip | 15692-1279
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Country | US
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Telephone |
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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 | 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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