Individual
MARILYN BONEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6 PARKLANE BLVD STE 695, DEARBORN, MI 48126-2776
(313) 271-8170
(313) 271-8353
Mailing address
6400 HEAVEN DR, HOWELL, MI 48855-9409
(734) 417-2531
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
6301007264
MI
Other
Enumeration date
03/18/2019
Last updated
06/11/2019
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