Provider Demographics
NPI:1447525969
Name:THURSTON-SNOHA, BONNIE-JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:BONNIE-JEAN
Middle Name:
Last Name:THURSTON-SNOHA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20534-0004
Mailing Address - Country:US
Mailing Address - Phone:202-616-3220
Mailing Address - Fax:
Practice Address - Street 1:400 1ST ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20534-5429
Practice Address - Country:US
Practice Address - Phone:202-616-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1009103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral