MEDICARE: BONNIE SUDOWSKI

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1477000800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE SUDOWSKI

Provider Business Mailing Address
First Line	:	116 VIA D ESTE
Second Line	:	UNIT 402
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3959
Country	:	US
Telephone Number	:	860-235-5719
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 VIA D ESTE
Second Line	:	UNIT 402
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3959
Country	:	US
Telephone Number	:	860-235-5719
Fax Number	:

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

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	09/01/2016

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Directions to “ BONNIE SUDOWSKI ” Practice Location

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