Individual
ALYSSA BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
612 GOLD BEACH DR, CANUTILLO, TX 79835-8633
(915) 269-4411
Mailing address
612 GOLD BEACH DR, CANUTILLO, TX 79835-8633
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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