Individual
DEBORAH LYNN BONHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1269 DOCTORS DR, FARMINGTON, MO 63640-2947
(573) 664-1146
(573) 664-1149
Mailing address
1269 DOCTORS DR, FARMINGTON, MO 63640-2947
(573) 664-1146
(573) 664-1149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003618
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003618
LCSW LICENSE
MO
Enumeration date
05/19/2015
Last updated
05/19/2015
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