Individual
DR. BONNY GALE BRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
920 9 1 2 ST NE, CHARLOTTESVILLE, VA 22902-5311
(434) 984-1311
(434) 971-7740
Mailing address
920 9 1 2 ST NE, CHARLOTTESVILLE, VA 22902-5311
(434) 984-1311
(434) 971-7740
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810001884
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071737
ANTHEM
—
01
—
11510778
CAQH
—
05
—
7707983
—
VA
Enumeration date
11/08/2006
Last updated
07/08/2007
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