Individual
ANGELA D BONNEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 S MCHENRY AVE, CRYSTAL LAKE, IL 60014-7487
(815) 526-3750
Mailing address
445 HARVEST GATE, LAKE IN THE HILLS, IL 60156-4825
(847) 409-2746
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149013595
IL
Other
Enumeration date
02/23/2019
Last updated
02/23/2019
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