Individual
DAISY BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 W WALNUT ST STE 3100, ROGERS, AR 72756-3524
(479) 631-9996
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
(636) 946-0991
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8569-M
AR
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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