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Individual
DEANNA BONAVENTURA
Active
Individual
DEANNA BONAVENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3305
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082286
—
CT
05
—
008022626
—
CT
05
—
008056168
—
CT
05
—
008077565
—
CT
05
—
500000315
—
CT
Enumeration date
01/09/2018
Last updated
02/14/2018
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