Organization
BONHAM PSYCHOTHERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRA A BONHAM MSW, LICSW (CLINICAL SOCIAL WORKER)
(218) 256-0958
Entity
Organization
Contact information
Practice address
22991 KOLP RD, GRAND RAPIDS, MN 55744-6134
(218) 256-0958
Mailing address
22991 KOLP RD, GRAND RAPIDS, MN 55744-6134
(218) 256-0958
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/28/2023
Last updated
01/26/2024
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