Individual
MELISSA BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11220 38TH AVE APT 1F, CORONA, NY 11368-1447
(347) 255-8942
Mailing address
11220 38TH AVE APT 1F, CORONA, NY 11368-1447
(347) 255-8942
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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