Organization
BONNIE CRAEMER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE PETRIE CRAEMER LCSW (OWNER/PSCYHOTHERAPIST)
(770) 209-3908
Entity
Organization
Contact information
Practice address
2205 RIVERSTONE BLVD STE 273, CANTON, GA 30114-5250
(770) 209-3908
Mailing address
2205 RIVERSTONE BLVD STE 273, CANTON, GA 30114-5250
(770) 209-3908
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689997934
—
FL
Enumeration date
06/19/2022
Last updated
06/19/2022
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