Individual
DEBRA BONNIWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7985 MAIN ST, MIDDLETOWN, VA 22645-9543
(540) 868-1349
Mailing address
7985 MAIN ST, MIDDLETOWN, VA 22645-9543
(540) 868-1349
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003567
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215930573
—
VA
Enumeration date
11/18/2010
Last updated
05/12/2012
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