Provider Demographics
NPI:1831382886
Name:MULLER, BONNIE H (LCSW)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:H
Last Name:MULLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1513
Mailing Address - Country:US
Mailing Address - Phone:203-288-0579
Mailing Address - Fax:203-288-0579
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-288-0579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0019091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical