Individual
KYLE W BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1633 N CAPITOL AVE, STE 300, INDIANAPOLIS, IN 46202-1261
(317) 962-2700
(317) 963-5039
Mailing address
1633 N CAPITOL AVE, STE 300, INDIANAPOLIS, IN 46202-1261
(317) 962-2700
(317) 963-5039
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33007045A
IN
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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