Bonitz-Moore, Heather Jo
Bonitz-Moore, Heather Jo is an sole proprietor health care provider with primary practice located at 46 Lebanon Rd , Bozrah CT 06334-1116. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Bonitz-Moore, Heather Jo can be contacted via phone (860) 617-4082.Contact Information
Primary practice address
46 Lebanon Rd
Bozrah CT 06334-1116
Phone: (860) 617-4082
Fax: (860) 617-4082
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 001445 | Connecticut |
Profile Details
| NPI number | 1821165788 |
|---|---|
| LBN Legal business name | Bonitz-Moore, Heather Jo |
| Credentials | ATR-BC, LPC, IMH-E |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Mar 17th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821165788 | NPPES |
| Connecticut | MEDICAID | 004271433 |
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