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Individual

MICAH BONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LADAC-II

Contact information

Practice address
980 W HIGHWAY 25 70, NEWPORT, TN 37821-9006
(865) 805-0567
(423) 205-4023
Mailing address
8500 OLDE COLONY TRL APT 11, KNOXVILLE, TN 37923-6227

Taxonomy

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

Other

Enumeration date
07/30/2025
Last updated
07/30/2025
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