Anthony Bonner, BS

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Hamtrack, MI

NPI 1801222005 · NPPES record last updated Sep 19, 2013

Key facts

NPI
1801222005
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
4251 E. McNichols
Hamtrack, MI 48205
Phone
(313) 368-4600
NPI assigned
Sep 19, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

4251 E. McNichols
Hamtrack, MI 48205

Mailing address

17535 Manderson Rd
Detroit, MI 48203-4056
Phone (313) 495-4012

Other providers in Hamtrack, MI

All providers in Hamtrack, MI · Addiction (Substance Use Disorder) Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.