Individual
BONNIE JO IGIELSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5215 DOGWOOD DR, MILTON, FL 32570-5708
(850) 270-0640
Mailing address
3357 WELLINGTON RD, PENSACOLA, FL 32504-7469
(610) 506-3141
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33040
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871917005
—
FL
Enumeration date
01/10/2018
Last updated
12/28/2018
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