Individual
BONA LISA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
745 W BRIDGE ST, BLACKFOOT, ID 83221-2000
(208) 680-2143
Mailing address
210 W BURNSIDE AVE, CHUBBUCK, ID 83202-4916
(208) 238-9000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-34255
ID
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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