Individual
BONITA E STUBBENDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 785-0001
(608) 785-0002
Mailing address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 785-0001
(608) 785-0002
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3245-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130820
—
MN
05
—
40931300
—
WI
01
—
HP66993
HEALTHPARTNERS
MN
Enumeration date
01/17/2007
Last updated
07/09/2010
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