Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 93573 | CA |
Y | 101YM0800X | Mental Health Counselor | 93573 | CA |
N | 225C00000X | Rehabilitation Counselor | 93573 | CA |
NPI | 1023434362 |
---|---|
Provider Name | Bonnie Lockhart |
First Address | Ukiah, CA 95482-2077 |
Second Address | Ukiah, CA 95482-3410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2014 |
Last Update Date | 03/02/2020 |