Provider Demographics
NPI:1043377674
Name:SENA, BONNIE (MSSW)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:SENA
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 ALPINE PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-3214
Mailing Address - Country:US
Mailing Address - Phone:513-281-7006
Mailing Address - Fax:513-281-5170
Practice Address - Street 1:2142 ALPINE PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-3214
Practice Address - Country:US
Practice Address - Phone:513-281-7006
Practice Address - Fax:513-281-5170
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00021241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW22731Medicare PIN