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General NPI Number Information
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NPI Number | 1801171376
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Entity Type | Individual
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Provider Name | BONNIE GRACE STANLEY M.ED.,ED.S.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 1350 N ORANGE AVE SUITE200
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City | WINTER PARK
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State | FL
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Zip | 32789-4945
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Country | US
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Telephone | 407-644-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 W WINGED FOOT CIR
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4203
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Country | US
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Telephone | 407-365-8994
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS996
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License Number State | FL
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