Most Relevant Information
Provider Data
| NPI Number: | 1003432766 |
| Provider Name: | MADISON BONASSO LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 2573 |
Most Important Dates
| Enumeration Date: | 06/18/2020 |
| Last Updated: | 02/22/2024 |
Provider Practice Location
1005 WHITE WILLOW WAY
MORGANTOWN
WV
265056119
Practice Location Phone/Fax
| Phone: | 3044605123 |
| Fax: |
Provider Mailing Location
1005 WHITE WILLOW WAY
MORGANTOWN
WV
265056119
Provider Mailing Phone/Fax
| Phone: | 3044605123 |
| Fax: |