Individual
JESILEE BONOFIGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3330 CLAYSTONE ST SE, GRAND RAPIDS, MI 49546-7716
(800) 968-6866
(616) 532-7230
Mailing address
PO BOX 30516, LANSING, MI 48909-8016
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801088826
MI
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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