Wickstrom, Bonita Rae
Wickstrom, Bonita Rae is an individual health care provider with primary practice located at 12836 Lomas Blvd Ne Suite B, Albuquerque NM 87112-6210. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Wickstrom, Bonita Rae can be contacted via phone (505) 453-7862.Contact Information
Primary practice address
12836 Lomas Blvd Ne Suite B
Albuquerque NM 87112-6210
Phone: (505) 453-7862
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | I-4390 | New Mexico |
Profile Details
| NPI number | 1225075161 |
|---|---|
| LBN Legal business name | Wickstrom, Bonita Rae |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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