| NPI | 1174856496 |
|---|---|
| Former Name | LISA BONORDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 21387) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 06692) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2012-02-15 |