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Individual

MRS. BONNIE SHAFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
40880 PEDDER RD., BIG BEAR LAKE, CA 92315
(909) 366-0545
(909) 366-0545
Mailing address
PO BOX 578, SKYFOREST, CA 92385-0578
(909) 366-0545
(909) 366-0545

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
RI-S1307181042
CA

Other

Enumeration date
11/07/2013
Last updated
11/07/2013
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