Individual
BRIDGETTE LEE BONIFAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 RAINBOW CT, FAIRBORN, OH 45324-6365
(937) 641-3401
(937) 641-3046
Mailing address
PO BOX 933421, CLEVELAND, OH 44193-0039
(937) 641-4000
(937) 641-4500
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.2303747
OH
Other
Enumeration date
07/11/2018
Last updated
10/07/2023
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