Individual
CHRISTOPHER OMAR BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSWA
Contact information
Practice address
1909 J N PEASE PL STE 101, CHARLOTTE, NC 28262-4509
(980) 621-8401
Mailing address
1000 BROOKRUN DR APT 1313, CHARLOTTE, NC 28209-2944
(704) 648-3473
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P017752
NC
Other
Enumeration date
07/06/2022
Last updated
07/13/2022
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