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Individual
MRS. REGINA CAROL BONYNGE
Active
Individual
MRS. REGINA CAROL BONYNGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2091
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2091
OT LICENSE
FL
01
—
P00458291
RAILROAD MEDICARE
FL
01
—
Z5555
BLUE CROSS & BLUE SHIELD
FL
Enumeration date
05/02/2006
Last updated
12/16/2009
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