Individual
MRS. TARA TERINA BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1740 FOREST LN, RICHMOND, KY 40475-3638
(859) 779-3529
Mailing address
1740 FOREST LN, RICHMOND, KY 40475-3638
(859) 779-3529
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3546
KY
Other
Enumeration date
07/10/2007
Last updated
03/09/2017
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