Individual
LUISA BONIFACIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
800 POLY PL, BROOKLYN, NY 11209-7104
(718) 836-6600
Mailing address
1 SAINT PAULS CT APT 6E, BROOKLYN, NY 11226-2829
(917) 755-3615
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
022562
NY
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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