Individual
MR. CLARENCE LEONARD BONANDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
817 MAIN ST N, CAMBRIDGE, MN 55008-1275
(763) 325-0300
(763) 325-0301
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 379-1704
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
GL0087
MN
Other
Enumeration date
08/23/2016
Last updated
04/09/2019
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