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1255745873
CHIVVON BONILLA
LOUISVILLE, KY
NPI
1255745873
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32002663A)
Enumeration Date
2014-06-12
Last Update Date
2014-06-12
Business Address
-- CHIVVON BONILLA COTA/L
303 N HURSTBOURNE PKWY STE 200
LOUISVILLE, KY 40222-5158
Phone number: 502-412-5847
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Mailing Address
-- CHIVVON BONILLA COTA/L
1400 E 51ST PL
GARY, IN 46409-2937
Phone number: 219-713-7863
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