Individual
MS. JACQUELINE BONSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2018 WESTERN AVE, KNOXVILLE, TN 37921-5718
(865) 544-0406
(865) 544-0480
Mailing address
6350 W ANDREW JOHNSON HWY, DEPARTMENT 100, TALBOTT, TN 37877-8605
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
3492
TN
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2015
Last updated
03/27/2018
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