Individual
MS. BONNIE M HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
602 S WEDGEWOOD LN, CARBONDALE, IL 62901-2119
(618) 303-1654
Mailing address
602 S WEDGEWOOD LN, CARBONDALE, IL 62901-2119
(618) 303-1654
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
101Y00000X
IL
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/21/2008
Last updated
01/31/2012
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