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SERGIO BONILLA

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1043754682

Individual Registrant:
 SERGIO  BONILLA 
Gender: M
Sole Proprietor

Location and contact information for practice:
50 FARENHOLT ST. BLDG. HAGATNA, GU 96910 US
Tel: 971-687-7370  Fax: --

Contact information for business:
50 FARENHOLT ST. BLDG. HAGATNA, GU 96910 US
Tel: --  Fax: --

Registration Information:
NPI: 1043754682
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
FLSW13997

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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