Individual
MRS. BONNIE B ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
RR 3 BOX 414, LAWRENCEVILLE, IL 62439-9499
(618) 943-3754
(618) 943-5766
Mailing address
RR 3 BOX 414, LAWRENCEVILLE, IL 62439-9499
(618) 943-3754
(618) 943-5766
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.007390
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376006178008
—
IL
Enumeration date
01/10/2007
Last updated
03/04/2016
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