Provider Demographics
NPI:1851304554
Name:BOHNEN, CAROLYN JOANNE (MA)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JOANNE
Last Name:BOHNEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EAST MAIN STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:360-794-4830
Mailing Address - Fax:360-793-6737
Practice Address - Street 1:125 EAST MAIN STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272
Practice Address - Country:US
Practice Address - Phone:360-794-4830
Practice Address - Fax:360-793-6737
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00000977106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist