Individual
MELISSA BONNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1000 E PARK BLVD STE 120, BOISE, ID 83712-7793
(208) 381-4100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(120) 838-1211
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW1305
ID
Other
Enumeration date
05/17/2022
Last updated
07/19/2022
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