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General NPI Number Information
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NPI Number | 1912515396
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Entity Type | Individual
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Provider Name | MISS JASMINE BONENFANT
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Gender | Female
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 5 KENNEY LN
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City | NORTH ATTLEBORO
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State | MA
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Zip | 02760-4148
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Country | US
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Telephone | 774-254-7189
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Fax |
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Provider Business Mailing Address
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Address Line | 9170 CROWNE SPRINGS VW APT 215
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-1278
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Country | US
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Telephone | 774-254-7189
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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 | 0021835
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License Number State | CO
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