Individual
JARED CHARLES BONNICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
43155 MAIN ST STE 2300, NOVI, MI 48375-1777
(734) 323-4897
(248) 946-8107
Mailing address
43155 MAIN ST STE 2300, NOVI, MI 48375-1777
(734) 323-4897
(248) 946-8107
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361008192
MI
106S00000X
Behavior Technician
RBT-19-78419
IL
Other
Enumeration date
02/13/2019
Last updated
07/24/2025
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