Individual
BONNY MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
702 S PALESTINE ST, ATHENS, TX 75751-3325
(903) 675-9595
(903) 677-2110
Mailing address
PO BOX 2536, ATHENS, TX 75751-7536
(903) 675-9595
(903) 677-2110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S14353
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108313102
—
TX
Enumeration date
01/08/2007
Last updated
09/27/2011
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