Individual
KIMBERLY BONIKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
14145 SIMONE DR, SHELBY TWP, MI 48315-3228
(586) 566-6280
Mailing address
45350 DANTE DR, MACOMB, MI 48042-5524
(586) 566-6280
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007400
MI
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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