Individual
MS. BONITA GAYE KINGSTEINKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MH, CTHA
Contact information
Practice address
1713 BECK AVE, SUITE B, PANAMA CITY, FL 32405-2566
(850) 403-8017
Mailing address
7004 OAKENSHAW DR, YOUNGSTOWN, FL 32466-8380
(619) 322-2595
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
270697
CA
Other
Enumeration date
03/21/2015
Last updated
04/27/2015
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