Individual
BONNIE L MUGRAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDCII
Contact information
Practice address
507 MULBERRY HEIGHTS RD, POMEROY, OH 45769-9573
(740) 992-5277
(740) 992-7264
Mailing address
224 COLUMBUS RD, ATHENS, OH 45701-1334
(740) 592-6724
(740) 592-6728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
011066
OH
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864002
—
OH
Enumeration date
04/05/2018
Last updated
02/13/2024
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