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General NPI Number Information
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NPI Number | 1922134006
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Entity Type | Individual
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Provider Name | JANE BONK-THOMSON L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 700 UNIVERSE BLVD EAP/JB
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City | JUNO BEACH
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State | FL
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Zip | 33408-2657
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Country | US
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Telephone | 561-236-1207
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Fax | 561-691-7899
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Provider Business Mailing Address
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Address Line | 700 UNIVERSE BLVD EAP/JB
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City | JUNO BEACH
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State | FL
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Zip | 33408-2657
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Country | US
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Telephone | 561-236-1207
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Fax | 561-691-7899
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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 | SW2122
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License Number State | FL
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