Most Relevant Information
Provider Data
| NPI Number: | 1003341272 |
| Provider Name: | MARC BONAGUIDE LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 006548 |
Most Important Dates
| Enumeration Date: | 04/25/2017 |
| Last Updated: | 04/25/2017 |
Provider Practice Location
10 SUNRISE TER
WEATOGUE
CT
060899755
Practice Location Phone/Fax
| Phone: | 8609511240 |
| Fax: |
Provider Mailing Location
10 SUNRISE TER
WEATOGUE
CT
060899755
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |