Provider Demographics
NPI:1447651666
Name:BISHOP, BONNIE
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IECE
Mailing Address - Street 1:630 WILLOUGHBYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40337-8309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 WILLOUGHBYTOWN RD
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40337-8309
Practice Address - Country:US
Practice Address - Phone:859-499-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-07
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist