Debban, Bonita Jean

Debban, Bonita Jean is an individual health care provider with primary practice located at 970 S Silver Lake St , Oconomowoc WI 53066-3802. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Debban, Bonita Jean can be contacted via phone (262) 567-7900.

Contact Information

Primary practice address
970 S Silver Lake St Oconomowoc WI 53066-3802
Phone: (262) 567-7900
Fax: (262) 567-7908
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2324-057 Wisconsin

Profile Details

NPI number 1144274689
LBN Legal business name Debban, Bonita Jean
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1144274689 NPPES
Wisconsin MEDICAID 43550000
Wisconsin Other 412024650011

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