| NPI | 1386955052 |
|---|---|
| Former Name | BONNIE MARIE STROUD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2007029977) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH 9030) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2011-07-06 |