Individual
SAMIYRA BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 HADDONFIELD RD, PENNSAUKEN, NJ 08109-3376
(856) 406-0035
Mailing address
849 CUMBERLAND ST, GLOUCESTER CITY, NJ 08030-1806
(302) 509-7274
(302) 509-7274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-461314
NJ
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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