Individual
LEAH BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LLP
Contact information
Practice address
888 W BIG BEAVER RD STE 1450, TROY, MI 48084-4762
(248) 244-8644
Mailing address
888 W BIG BEAVER RD STE 1450, TROY, MI 48084-4762
(248) 244-8644
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301018128
MI
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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