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NPI Code Detail

MEDICARE: MS. BONNIE KAY MARKS LMFT

MEDICARE: MS. BONNIE KAY MARKS LMFT
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
1106H00000XMarriage & Family TherapistMFT140HI
2106H00000XMarriage & Family Therapist890CO
3106H00000XMarriage & Family TherapistMFC36793CA

General Provider Information

NPI Number : 1184833881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BONNIE KAY MARKS LMFT
Provider Business Mailing Address
First Line : 1814 AQUILA DR
Second Line :
City : PUEBLO
State : CO
Zip : 81008-2617
Country : US
Telephone Number : 719-924-8266
Fax Number : 719-924-8266
Provider Business Practice Location Address
First Line : 1115 N GRAND AVE
Second Line : SUITE 201
City : PUEBLO
State : CO
Zip : 81003-2867
Country : US
Telephone Number : 719-544-1404
Fax Number : 719-544-1404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 09/24/2009

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