| NPI | 1023391505 |
|---|---|
| Former Name | BONNIE BOSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 3294C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 2475-M) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2020-03-16 |