Individual
DR. BIANCA CAMILLE LUIGI BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-5800
Mailing address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-5800
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5478
PR
103TC1900X
Counseling Psychologist
5478
PR
Other
Enumeration date
01/23/2016
Last updated
01/29/2024
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