Individual
ANTHONY BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
4251 E. MCNICHOLS, HAMTRACK, MI 48205
(313) 368-4600
Mailing address
17535 MANDERSON RD, DETROIT, MI 48203-4056
(313) 495-4012
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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