Individual
MR. DANIEL M BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW-CC
Contact information
Practice address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
Mailing address
30 PIERCE ST, SOUTH PORTLAND, ME 04106-2113
(207) 767-2452
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ME194805
ME
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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