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Individual

LEANNA MASHAE BONNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
709 DAVIDSON ST, TULLAHOMA, TN 37388-3607
(931) 393-5900
(931) 393-5902
Mailing address
4523 JUDITH LN SW, APT. 5, HUNTSVILLE, AL 35805-3388

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/11/2008
Last updated
03/11/2008
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Product
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