Individual
MICHAEL BONDURANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC III
Contact information
Practice address
8745 COUNTY ROAD 9 S, ALAMOSA, CO 81101-9610
(719) 589-3671
Mailing address
8745 COUNTY ROAD 9 S, ALAMOSA, CO 81101-9610
(719) 589-3671
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0020918
CO
101YM0800X
Mental Health Counselor
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Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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