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General NPI Number Information
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NPI Number | 1356736128
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Entity Type | Individual
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Provider Name | KIRSTEN BONNELL MS MHC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 10 N MAIN ST
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City | CORTLAND
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State | NY
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Zip | 13045-2130
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Country | US
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Telephone | 607-753-0234
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Fax | 607-299-4349
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Provider Business Mailing Address
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Address Line | 201 CEDAR ST
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City | ONEIDA
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State | NY
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Zip | 13421-2111
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Country | US
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Telephone | 315-280-0400
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Fax | 315-280-0087
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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