Individual
JESSICA KATHLEEN BONATAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
22 NORTHEAST DR, HERSHEY, PA 17033-2732
(717) 531-8338
(717) 531-6250
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
129694
KY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS018803
PA
Other
Enumeration date
09/01/2009
Last updated
06/21/2021
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