| Doctor Name: | MICHAEL B BONEBRAKE |
| NPI Number: | 1003919549 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LSCSW |
| License Number: | 1446 |
| Business Practice Address: | 240 N Rock Road Suite 303 Wichita, KS - 67206 |
| Business Phone Number: | 3166833841 |
| Business Fax Number: | 3166867366 |
| Mailing Address: | 240 N Rock Road, Suite 303 WICHITA |
| State: | KS |
| Postal Code: | 67206 |
| Phone Number: | 3166833841 |
| Fax Number: | 3166867366 |
| NPI Enumeration Date: | 09/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1446 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |