Individual
DR. KELLY JAMES BONEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
977 ADA PLACE DR SE, GRAND RAPIDS, MI 49546-8412
(616) 460-3341
Mailing address
3721 DURSUM AVE NE, ADA, MI 49301-9718
(616) 308-1503
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401008653
MI
Other
Enumeration date
07/26/2006
Last updated
05/11/2020
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