| Bonham Psychotherapy Services | |
|
22991 Kolp Rd Grand Rapids MN 55744-6134 | |
| (218) 256-0958 | |
| Not Available |
| Full Name | Bonham Psychotherapy Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 22991 Kolp Rd, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Darra A Bonham (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2182560958 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonham Psychotherapy Services 22991 Kolp Rd Grand Rapids MN 55744-6134 Ph: (218) 256-0958 | Bonham Psychotherapy Services 22991 Kolp Rd Grand Rapids MN 55744-6134 Ph: (218) 256-0958 |
| NPI Number | 1457127722 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 01/26/2024 |
| Certification Date | 01/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457127722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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