Basic Information
| Provider Information | |||||||||
| NPI: | 1750835096 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BONDHUS | ||||||||
| FirstName: | LOIA | ||||||||
| MiddleName: | CLOUD | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | HOT SPRINGS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10025 WEST MARKHAM ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016635473 | ||||||||
| FaxNumber: | 5018011816 | ||||||||
| Practice Location | |||||||||
| Address1: | 3604 CENTRAL AVE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 71913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016239220 | ||||||||
| FaxNumber: | 5016239227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2016 | ||||||||
| LastUpdateDate: | 01/24/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 7923-M | AR | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.