Individual
MRS. TYLISAEA BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
156 TALON DE SE, RYDAL, GA 30171
(404) 851-7204
Mailing address
156 TALON DE SE, RYDAL, GA 30171
(404) 851-7204
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW011690
GA
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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