MEDICARE: DR. BONNIE DANSKY COTTON PH.D.

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	103TB0200X	Cognitive & Behavioral Psychologist	8439	FL
2	103TC0700X	Clinical Psychologist	8439	FL

General Provider Information

NPI Number	:	1225560873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNIE DANSKY COTTON PH.D.

Provider Business Mailing Address
First Line	:	7003 SW WISTERIA TER
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-5238
Country	:	US
Telephone Number	:	772-631-8382
Fax Number	:

Provider Business Practice Location Address
First Line	:	7003 SW WISTERIA TER
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-5238
Country	:	US
Telephone Number	:	772-631-8382
Fax Number	:

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

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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