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Individual

STEPHEN BERT BONDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
6729-D FAIRVIEW RD, CHARLOTTE, NC 28210-3358
(704) 442-9111
(704) 442-0021
Mailing address
6729 FAIRVIEW RD STE D, CHARLOTTE, NC 28210-0127
(704) 442-9111
(704) 442-0021

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
0271
NC
103TC0700X
Clinical Psychologist
Primary
0271
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0271
LICENSE #
NC
01
03142
BCBSNC
NC
Enumeration date
08/06/2007
Last updated
10/05/2011
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