Individual
MR. RICHARD DAVID BONHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
205 N AUBURN AVE, FARMINGTON, NM 87401-8411
(505) 564-3733
(505) 564-3788
Mailing address
205 N AUBURN, FARMINGTON, NM 87401
(505) 564-3733
(505) 564-3788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5447
NM
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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