Individual
JOSEPHINE BONOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 N PECOS RD, LAS VEGAS, NV 89101-2408
(702) 455-4654
Mailing address
601 N PECOS RD, LAS VEGAS, NV 89101-2408
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0815
NV
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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