Individual
MR. SHANE HAROLD BONELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. COUN., LPC
Contact information
Practice address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
(541) 955-7444
Mailing address
1545 HARBECK RD, GRANTS PASS, OR 97527-5605
(541) 476-2373
(541) 955-7444
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2795
OR
Other
Enumeration date
09/30/2010
Last updated
02/07/2024
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