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Individual

MRS. BONNIE HOPE KURTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW-R

Contact information

Practice address
22 FAVORITE LN, JERICHO, NY 11753-2347
(516) 456-3944
Mailing address
22 FAVORITE LN, JERICHO, NY 11753-2347

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
051434
NY
1041C0700X
Clinical Social Worker
051434
NY
1041S0200X
School Social Worker
051434
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051434
NEW YORK STATE LICENSE NUMBER
NY
Enumeration date
10/20/2009
Last updated
10/20/2009
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