Individual
MR. MICHAEL JOSEPH BONIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCSW, LCSW
Contact information
Practice address
1900 W 75TH ST, SUITE 120, PRAIRIE VILLAGE, KS 66208-3502
(913) 384-6542
(913) 384-4629
Mailing address
1900 W 75TH ST, SUITE 120, PRAIRIE VILLAGE, KS 66208-3502
(913) 384-6542
(913) 384-4629
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCSW #1548
MO
1041C0700X
Clinical Social Worker
Primary
LSCSW #891
KS
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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