Individual
KANDIS BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2628 RING RD STE 105, ELIZABETHTOWN, KY 42701-9123
(270) 215-5959
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-421134
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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