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1134584105
BLAINE ALAN BONNETT
BOSSIER CITY, LA
NPI
1134584105
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: LA 5858)
Enumeration Date
2015-12-17
Last Update Date
2015-12-17
Business Address
-- BLAINE ALAN BONNETT MSW
5903 STOCKWOOD ST
BOSSIER CITY, LA 71111-5607
Phone number: 318-510-7034
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Mailing Address
-- BLAINE ALAN BONNETT MSW
5903 STOCKWOOD ST
BOSSIER CITY, LA 71111-5607
Phone number: 318-510-7034
Copy
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