Provider Demographics
NPI:1447606504
Name:BONURA, AMBER (PLPC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BONURA
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:OSTARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1141 WHITNEY AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5011
Mailing Address - Country:US
Mailing Address - Phone:504-347-1120
Mailing Address - Fax:504-347-1782
Practice Address - Street 1:1141 WHITNEY AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5011
Practice Address - Country:US
Practice Address - Phone:504-347-1120
Practice Address - Fax:504-347-1782
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)