Individual
MS. BONNIE L EDELBLUTE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3505 WESTERN AVE, KINGMAN, AZ 86409-3011
(928) 757-8111
(928) 757-3256
Mailing address
1743 SYCAMORE AVE, MOHAVE MENTAL HEALTH CLINIC INC, KINGMAN, AZ 86409-0927
(928) 757-8111
(928) 757-3256
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC1531
AZ
Other
Enumeration date
10/11/2005
Last updated
07/08/2007
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