Individual
MRS. MICHELLE R BONADIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2100 N MAIN ST # 304, CROWN POINT, IN 46307-1877
(574) 546-1900
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149.014226
IL
1041C0700X
Clinical Social Worker
Primary
34007036A
IN
Other
Enumeration date
03/08/2011
Last updated
06/03/2022
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