Individual
PAMELA BONENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
110 POPLAR STREET, KADOKA, SD 57543
(605) 837-2731
Mailing address
PO BOX 483, KADOKA, SD 57543-0483
(605) 837-2731
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
028577-01
SD
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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