Hollan Beth Bonjukian, CPT, CNC, BA
Specialist in Averill Park, NY. Individual provider (NPI-1).
NPI number1376809079
StatusActive
Last updated in NPPESApr 6, 2012
Details
- NPI
- 1376809079
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Hollan Beth Bonjukian
- Credential
- CPT, CNC, BA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 6, 2012
- Last updated
- Apr 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
| 133N00000X | Nutritionist | – | – | |
| 174H00000X | Health Educator | – | – |
Practice location
36 Whitney DrAverill Park, NY 12018-3754
Phone 518-496-0337
Mailing address
36 Whitney DrAverill Park, NY 12018-3754
Phone 518-496-0337
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