Provider Demographics
NPI:1174229272
Name:BONN, SUSANNAH (MFT)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:
Last Name:BONN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SUZY
Other - Middle Name:
Other - Last Name:BONN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:1813 SPRUCE ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1818 RITTENHOUSE SQ
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5837
Practice Address - Country:US
Practice Address - Phone:215-839-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist