Individual
BROOK FAYE BONNEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1704 MCDOWELL BND, LEANDER, TX 78641-2197
(512) 791-4115
Mailing address
1704 MCDOWELL BND, LEANDER, TX 78641-2197
(512) 791-4115
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
74315
TX
101YM0800X
Mental Health Counselor
Primary
74315
TX
101YP2500X
Professional Counselor
74315
TX
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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