Provider Demographics
NPI:1316344864
Name:BONNER, ABRIA J (LMSW)
Entity type:Individual
Prefix:
First Name:ABRIA
Middle Name:J
Last Name:BONNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 SPRINGS LN
Mailing Address - Street 2:APT E
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-6848
Mailing Address - Country:US
Mailing Address - Phone:917-870-9963
Mailing Address - Fax:
Practice Address - Street 1:6900 SPRINGS LN
Practice Address - Street 2:APT E
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-6547
Practice Address - Country:US
Practice Address - Phone:917-870-9963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-28
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0069611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical