Provider Demographics
NPI:1063151785
Name:AKERSON, BONNIE (MBA, INHC)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:AKERSON
Suffix:
Gender:F
Credentials:MBA, INHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1264
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-5264
Mailing Address - Country:US
Mailing Address - Phone:781-797-0309
Mailing Address - Fax:
Practice Address - Street 1:80 HAYDEN AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7967
Practice Address - Country:US
Practice Address - Phone:781-797-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach