Individual
BONITA WALDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1019 WESTSIDE DR, CUBA, MO 65453-1025
(573) 885-1607
(573) 885-0428
Mailing address
404 MAGNOLIA ST, CUBA, MO 65453-1924
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1999140933
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494838311
—
MO
Enumeration date
01/25/2006
Last updated
10/26/2009
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