MEDICARE: BONNIE MAE ANDERSON

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	101YM0800X	Mental Health Counselor	PC-0012010	DE

General Provider Information

NPI Number	:	1104776491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE MAE ANDERSON

Provider Business Mailing Address
First Line	:	54 S STATE ST
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19901-7312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 S STATE ST
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19901-7312
Country	:	US
Telephone Number	:	302-257-2385
Fax Number	:

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

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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Directions to “ BONNIE MAE ANDERSON ” Practice Location

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