Provider Demographics
NPI:1982909578
Name:BONT, ANITA MELODEE (MS, MFT)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:MELODEE
Last Name:BONT
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 711
Mailing Address - Street 2:144 N. ADAMS STREET
Mailing Address - City:ST. CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024
Mailing Address - Country:US
Mailing Address - Phone:651-792-5911
Mailing Address - Fax:715-483-3098
Practice Address - Street 1:144 N. ADAMS STREET
Practice Address - Street 2:
Practice Address - City:ST. CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024
Practice Address - Country:US
Practice Address - Phone:651-792-5911
Practice Address - Fax:715-483-3098
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist