Individual
BONNIE D WEBSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
222 W BROADWAY, MOUNTAINAIR, NM 87036
(505) 847-2320
(505) 847-2995
Mailing address
2960 RODEO PARK DR. W, SANTA FE, NM 87505
(505) 986-9633
(505) 473-3038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
T-CTL0212501
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103356609
—
NM
Enumeration date
06/18/2013
Last updated
07/29/2020
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