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Individual

ANITA BONNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CASAC

Contact information

Practice address
3 CORPORATE DR, PEEKSKILL, NY 10566-1846
(914) 257-3500
Mailing address
3 CORPORATE DR, PEEKSKILL, NY 10566-1846
(914) 257-3500

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12092
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12092
CASAC
NY
Enumeration date
06/03/2016
Last updated
06/03/2016
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