| Doctor Name: | BONNIE LILLIS |
| NPI Number: | 1154599629 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA |
| License Number: | |
| Business Practice Address: | 110 National Dr Glastonbury, CT - 060334371 |
| Business Phone Number: | 8604305515 |
| Business Fax Number: | 8604309754 |
| Mailing Address: | 50 Griswold St, NEW BRITAIN |
| State: | CT |
| Postal Code: | 060522008 |
| Phone Number: | 8602245267 |
| Fax Number: | 8602245752 |
| NPI Enumeration Date: | 02/18/2008 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |