Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1184920241 |
---|---|
Provider Name | Bonnie Bare |
First Address | Carson City, NV 89701 |
Second Address | Battle Mountain, NV 89820-2834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2011 |
Last Update Date | 28/12/2021 |