Organization
JONNA MARIE CAPIO LMHC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONNA M CAPIO LMHC (TIN OWNER)
(812) 331-7773
Entity
Organization
Contact information
Practice address
3925 E HAGAN ST STE 307, BLOOMINGTON, IN 47401-8649
(812) 331-7773
Mailing address
4972 E HERITAGE WOODS RD, BLOOMINGTON, IN 47401-9175
(812) 331-7773
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39002467A
IN
101YM0800X
Mental Health Counselor
39002467A
IN
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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