Individual
DEIRDRE BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
6046 TRAVIATA AVE, LAS VEGAS, NV 89141-0477
(702) 381-2446
Mailing address
6046 TRAVIATA AVE, LAS VEGAS, NV 89141-0477
(702) 381-2446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
06722-LC
NV
101YM0800X
Mental Health Counselor
Primary
CP5140
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100544052
—
NV
Enumeration date
10/13/2015
Last updated
10/07/2023
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