Individual
TINA MARIE SMITH-BONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
1034 NW 57 STREET SUITE C, GAINESVILLE, FL 32605
(352) 332-9015
(352) 332-9941
Mailing address
2346 NW 14 PLACE, GAINESVILLE, FL 32605
(352) 332-9015
(352) 332-9941
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5574
FL
Other
Enumeration date
05/28/2008
Last updated
05/28/2008
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