Individual
BONNIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4097
Mailing address
2981 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 712-2902
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2013035565
MO
1041C0700X
Clinical Social Worker
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—
Other
Enumeration date
05/12/2014
Last updated
02/24/2025
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