MEDICARE: BONNIE A SZYMANSKI LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-1168	AZ

General Provider Information

NPI Number	:	1063595981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE A SZYMANSKI LPC

Provider Business Mailing Address
First Line	:	2700 N 3RD ST
Second Line	:	SUITE 2008
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1129
Country	:	US
Telephone Number	:	602-264-4600
Fax Number	:	602-264-7325

Provider Business Practice Location Address
First Line	:	2700 N 3RD ST
Second Line	:	SUITE 2008
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1129
Country	:	US
Telephone Number	:	602-264-4600
Fax Number	:	602-264-7325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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