Individual
BETHANY BONIFANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5301 BRYANT IRVIN RD, FORT WORTH, TX 76132-4030
(817) 422-0561
Mailing address
7201 WIND CHIME DR, FORT WORTH, TX 76133-7001
(318) 676-9179
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
115695
TX
Other
Enumeration date
09/21/2020
Last updated
11/27/2023
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