Individual
MRS. KATHERINE I BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LADC
Contact information
Practice address
872 MAIN ST, WILLIMANTIC, CT 06226-2342
(860) 985-3494
Mailing address
44 ASHFORD LAKE DR, ASHFORD, CT 06278-1201
(860) 646-3888
(860) 645-4132
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
010124
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001366
MASTER'S LEVEL SOCIAL WORKER
CT
Enumeration date
09/12/2012
Last updated
04/09/2019
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