Individual
DR. KATHLEEN MARIE BONEBRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108
(801) 587-8626
Mailing address
32 O STREET, SALT LAKE CITY, UT 84103-3040
(435) 559-2829
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10505880-1205
UT
Other
Enumeration date
03/26/2016
Last updated
10/28/2021
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