NPI | 1487096376 |
---|---|
Doing Business As | BONIFACIO MENTAL HEALTH |
Entity Type | Organization |
Authorized Contact | MARGARET H BONIFACIO Owner/Provider 865-387-2904 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APM0000017637) |
Enumeration Date | 2013-07-22 |
Last Update Date | 2019-04-12 |