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Individual

PAUL JAY BONUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
245 W RACE ST, SOMERSET, PA 15501-1922
(814) 443-4891
Mailing address
25 6TH ST, CAIRNBROOK, PA 15924-9701
(814) 279-8426

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Enumeration date
03/30/2021
Last updated
03/30/2021
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