Individual
KRISTIN M BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC AADC
Contact information
Practice address
6 COSTANZO CT, HAMDEN, CT 06518-2464
(203) 556-4969
Mailing address
6 COSTANZO CT, HAMDEN, CT 06518-2464
(203) 556-4969
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000035
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000035
CT DPH
CT
Enumeration date
05/02/2019
Last updated
05/02/2019
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