Individual
MS. BONNIE JANE WYANT-HEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
111 E MAIN ST, ELKTON, MD 21921-5996
(443) 406-3234
Mailing address
111 E MAIN ST, ELKTON, MD 21921-5996
(443) 406-3234
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACO204
MD
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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