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Individual

CHANTE BONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1515 MARTIN BLVD, MIDDLE RIVER, MD 21220-4103
(443) 241-5488
Mailing address
1101 N FULTON AVE, BALTIMORE, MD 21217-1506
(443) 703-9679

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22969
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22969
LMSW
MD
Enumeration date
02/16/2023
Last updated
02/16/2023
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