Individual
ELAINE-MARIE BONITATIBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
147 MONT VERNON RD, NEW BOSTON, NH 03070-3900
(603) 213-3630
Mailing address
PO BOX 102, NEW BOSTON, NH 03070-0102
(336) 486-7971
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
121080
MA
1041C0700X
Clinical Social Worker
1628
NH
1041C0700X
Clinical Social Worker
Primary
C0065557
NC
Other
Enumeration date
03/03/2008
Last updated
09/03/2020
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