Most Relevant Information
Provider Data
| NPI Number: | 1003303231 |
| Provider Name: | BONITA JO KLOPACH MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | MSW006828 |
Most Important Dates
| Enumeration Date: | 04/13/2018 |
| Last Updated: | 04/13/2018 |
Provider Practice Location
4343 SHALLOWFORD RD STE C-1
MARIETTA
GA
300625023
Practice Location Phone/Fax
| Phone: | 6787403757 |
| Fax: | 7709939800 |
Provider Mailing Location
4343 SHALLOWFORD RD STE C-1
MARIETTA
GA
300625023
Provider Mailing Phone/Fax
| Phone: | 6787403757 |
| Fax: | 7709939800 |