Provider Demographics
NPI:1215087572
Name:BONDELIER, SANDRA HOPE (LISW-S AND LCSW)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:HOPE
Last Name:BONDELIER
Suffix:
Gender:F
Credentials:LISW-S AND LCSW
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:HOPE
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:261 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD BAY
Mailing Address - State:AR
Mailing Address - Zip Code:72088-2708
Mailing Address - Country:US
Mailing Address - Phone:419-261-6818
Mailing Address - Fax:
Practice Address - Street 1:242 SHAKE RAG RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:AR
Practice Address - Zip Code:72031-6629
Practice Address - Country:US
Practice Address - Phone:419-261-6818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI40831041C0700X
AR7246-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical