Individual
MS. JENNIFER CANDACE BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
9548B MAIN ST, FAIRFAX, VA 22031-4031
(571) 746-9614
Mailing address
1925 ROLAND CLARKE PL APT 109, RESTON, VA 20191-1453
(843) 566-2570
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201002074
VA
231H00000X
Audiologist
3922
SC
237700000X
Hearing Instrument Specialist
2101002965
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3922
SC STATE LICENSE
SC
Enumeration date
03/03/2010
Last updated
07/28/2026
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