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NPI Code Detail

MEDICARE: MRS. ELIZABETH ANNA BONNYMAN MS.ED.

MEDICARE: MRS. ELIZABETH ANNA BONNYMAN MS.ED.
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
1103K00000XBehavior Analyst1383MA

General Provider Information

NPI Number : 1558544379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH ANNA BONNYMAN MS.ED.
Provider Business Mailing Address
First Line : 33 PERRY AVE
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-2417
Country : US
Telephone Number : 508-455-6200
Fax Number : 508-455-6211
Provider Business Practice Location Address
First Line : 33 PERRY AVE
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-2417
Country : US
Telephone Number : 508-455-6200
Fax Number : 508-455-6211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2007
Last Update Date : 01/13/2026

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