Individual
JEFFREY A BONACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, MDIV
Contact information
Practice address
2669 N RICHARDS ST, MILWAUKEE, WI 53212-2850
(800) 438-1772
(262) 345-5562
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-4799
(800) 438-1772
(262) 345-5562
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5121-226
WI
Other
Enumeration date
09/14/2020
Last updated
11/09/2021
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