Individual
MRS. BONNIE L CONNOLLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1 1/2 W GENEVA ST, CREDENCE THERAPY ASSOCIATES, ELKHORN, WI 53121-1722
(262) 723-3424
(262) 723-8308
Mailing address
1 1/2 W GENEVA ST, CREDENCE THERAPY ASSOCIATES, ELKHORN, WI 53121-1722
(262) 723-3424
(262) 723-8308
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LI2718125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1059860
CIGNA
—
01
—
13042
DEAN CARE
WI
01
—
39799400
HIRSP
WI
05
—
39799400
—
WI
Enumeration date
09/12/2005
Last updated
07/08/2007
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