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Individual

BONNIE EILEEN HALLETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
112 PARK AVE, WELLSVILLE, NY 14895-1162
(585) 593-7781
(585) 593-1291
Mailing address
112 PARK AVE, WELLSVILLE, NY 14895-1162
(585) 593-7781
(585) 593-1291

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R045218-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000526101001
BLUE CROSSBLUE SHEILD
01
00054374001
UNIVERA INS
01
00152483
NORTH AMERICAN PREFERRED
01
162167
VALUOPTIONS
05
71-02112027
NY
01
HB603100
GHI
Enumeration date
11/10/2006
Last updated
07/08/2007
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