Individual
HEATHER JO BONITZ-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR-BC, LPC, IMH-E
Contact information
Practice address
46 LEBANON RD, BOZRAH, CT 06334-1116
(860) 617-4082
(860) 617-4082
Mailing address
195 FOWLER RD, LEBANON, CT 06249-2503
(860) 617-4082
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001445
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004271433
—
CT
Enumeration date
11/29/2006
Last updated
03/17/2018
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