| Deslie Bonano, Lcsw, Bcd | |
|
703 W Canal St Picayune MS 39466-3918 | |
| (601) 749-9477 | |
| (601) 889-1265 |
| Full Name | Deslie Bonano, Lcsw, Bcd |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 703 W Canal St, Picayune, Mississippi |
| Authorized Official Name and Position | Deslie Bonano (LCSW) |
| Authorized Official Contact | 6017499477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deslie Bonano, Lcsw, Bcd 703 W Canal St Picayune MS 39466-3918 Ph: () - | Deslie Bonano, Lcsw, Bcd 703 W Canal St Picayune MS 39466-3918 Ph: (601) 749-9477 |
| NPI Number | 1336275064 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336275064 | NPI | - | NPPES |
| 00124843 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C6126 (Mississippi) | Primary |
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