| NPI | 1265957591 |
|---|---|
| Former Name | BONNIE LYNN HENNIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0104010122) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 002932) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-02-24 |