Individual
BIANCA BONNIWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
300 CATLIN ST, BUFFALO, MN 55313-2012
(763) 684-3888
Mailing address
18270 715TH AVE, DASSEL, MN 55325-7546
(320) 221-1579
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104457
MN
225XP0200X
Pediatric Occupational Therapist
—
MN
Other
Enumeration date
04/06/2014
Last updated
12/19/2019
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