Individual
BONNIE FAYE LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
13330 LEOPARD ST STE 34, CORPUS CHRISTI, TX 78410-4481
(361) 446-6460
Mailing address
3833 BROOKHAVEN DR, CORPUS CHRISTI, TX 78410-4401
(361) 446-6405
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
77005
TX
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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