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1043613516
JESSICA LORENA BONILLA
SMITHTOWN, NY
NPI
1043613516
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171400000X
Additional Taxonomies
235Z00000X Speech-Language Pathologist
(Licence: MD 07643)
Enumeration Date
2014-09-29
Last Update Date
2021-05-05
Business Address
MS. JESSICA LORENA BONILLA
156 LANDING MEADOW RD
SMITHTOWN, NY 11787-1100
Phone number: 631-626-6377
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Mailing Address
MS. JESSICA LORENA BONILLA
156 LANDING MEADOW RD
SMITHTOWN, NY 11787-1100
Phone number: 631-626-6377
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