Individual
KRISTY JO BONASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, ANN ARBOR, MI 48105-9484
(616) 920-4192
Mailing address
2276 MANCHESTER RD, ANN ARBOR, MI 48104-4922
(616) 920-4192
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
5201005302
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003878539
—
MI
Enumeration date
03/13/2018
Last updated
03/13/2018
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