Individual
MS. BONITA JO ANNE FRAZIER-SHEWMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMFT, NCC
Contact information
Practice address
512 6TH ST, RUPERT, ID 83350-1621
(208) 436-4911
(208) 436-1758
Mailing address
PO BOX 714, RUPERT, ID 83350-0714
(208) 436-4911
(208) 436-1758
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 3221
ID
106H00000X
Marriage & Family Therapist
LMFT 2673
ID
Other
Enumeration date
07/28/2013
Last updated
07/28/2013
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