Individual
MRS. KAITLYN ABIGAIL BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 NW 5TH ST STE D, MOORE, OK 73160-3947
(405) 208-4469
Mailing address
20711 JUANITA LN, TECUMSEH, OK 74873-5325
(325) 513-4288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8763
OK
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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