Individual
ALEXIS BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 PRICE PL STE 212, MADISON, WI 53705-3262
(608) 960-3534
Mailing address
4718 REGENT ST APT 95B, MADISON, WI 53705-4859
(715) 281-0633
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134316
LICENSE
WI
Enumeration date
08/31/2022
Last updated
02/23/2024
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