Individual
MICHAEL DEAN BONTRAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1807 SMITH ST, LOGANSPORT, IN 46947-1576
(574) 732-1414
(574) 732-0504
Mailing address
1807 SMITH ST, LOGANSPORT, IN 46947-1576
(574) 732-1414
(574) 732-0504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000388A
IN
Other
Enumeration date
03/09/2006
Last updated
09/22/2009
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