Individual
SESAR JESUS BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9801 VALLEY GROVE DR APT D, LOLO, MT 59847-8617
(406) 273-4633
Mailing address
2244 E VISTA DR, MISSOULA, MT 59803-2620
(406) 208-4788
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
72152
MT
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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