person
Dr. Bonita Marie Jackson-vergara, LICENSEDCOUNSELOR
Professional Counselor in Chesapeake, Virginia
NPI 1316967334

Bonita Marie Jackson-vergara is a Professional Counselor based in Chesapeake, VA and is specialized in Professional. Bonita Marie Jackson-vergara practices in Chesapeake, VA and has the professional credentials of LICENSEDCOUNSELOR. The NPI Number for Bonita Marie Jackson-vergara is 1316967334 and holds a License No. 0718000386 (Virginia).

The current practice location address for Bonita Marie Jackson-vergara is 1545 Crossways Blvd Ste 250, Chesapeake, VA and can be reached out via phone at 704-804-9614. You can also correspond with Bonita Marie Jackson-vergara through the mailing address at 800 FOX RIDGE TRL, CHESAPEAKE, VA - 23322-6506 (mailing address contact number: 704-804-9614).

Location: 1545 Crossways Blvd Ste 250, Chesapeake, VA, 23322-6506
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Provider Profile Details
NPI Number
1316967334
Provider Name
Bonita Marie Jackson-vergara
Credential
LICENSEDCOUNSELOR
Provider Entity Type
Individual
Gender
Female
Address
1545 Crossways Blvd Ste 250, Chesapeake, VA, 23322-6506
Phone Number
704-804-9614
Fax Number
Provider Enumeration Date
07/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6103317 05 NC
institution
Provider Business Practice Location Address Details
Address
1545 Crossways Blvd Ste 250
City
State
Zip
23320-0218
Phone Number
704-804-9614
Fax Number
person
Provider Business Mailing Address Details
Address
1545 Crossways Blvd Ste 250
City
State
Zip
23320-0218
Phone Number
704-804-9614
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
0701005902 (Virginia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
0718000386 (Virginia)
Definition
Definition to come...
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