Provider Demographics
NPI:1992247399
Name:JENKINS, BONNIE (RBT)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22211 SANDS POINT DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6267
Mailing Address - Country:US
Mailing Address - Phone:561-292-5199
Mailing Address - Fax:
Practice Address - Street 1:22211 SANDS POINT DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6267
Practice Address - Country:US
Practice Address - Phone:561-292-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician