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Individual

CATHY JO BONNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
130 SPRING AVE, FERGUSON, MO 63135-2345
(314) 819-3071
Mailing address
130 SPRING AVE, FERGUSON, MO 63135-2345
(314) 819-3071

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001834564
DAY CARE
MO
Enumeration date
09/18/2012
Last updated
09/18/2012
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