Individual
DR. BONNIE FONS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
415 W GRAND RIVER, EAST LANSING, MI 48823-4201
(517) 336-8005
(517) 333-8777
Mailing address
415 W GRAND RIVER, EAST LANSING, MI 48823-4201
(517) 336-8005
(517) 333-8777
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301006287
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5716466
AETNA
MI
01
—
620C34660
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/09/2006
Last updated
07/08/2007
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