Individual
DEWAYNE BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QBHP
Contact information
Practice address
1401 S. MAIN ST, HOPE, AR 71801
(870) 777-4848
Mailing address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
(501) 332-4403
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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