Provider Demographics
NPI:1447502737
Name:BONNER-DILLON, BRITTANY NICOLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:NICOLE
Last Name:BONNER-DILLON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SE WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2327
Mailing Address - Country:US
Mailing Address - Phone:330-340-7522
Mailing Address - Fax:
Practice Address - Street 1:130 SE WHITNEY ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2327
Practice Address - Country:US
Practice Address - Phone:330-340-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY31796103T00000X
WAPY61197410103T00000X
OHP07891103T00000X
OR3513103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health