Individual
MRS. BONITA L WEBER RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
Mailing address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1967 125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39777700
—
WI
Enumeration date
11/22/2006
Last updated
01/04/2012
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