NPI | 1043854813 |
---|---|
Former Name | MINDY LEE BONO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095903) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801106654) |
Enumeration Date | 2019-11-04 |
Last Update Date | 2021-02-08 |