Doctor Name: | MS. LILLIAN JOAN BONIN |
NPI Number: | 1558685263 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., L.M.H.C. |
License Number: | |
Business Practice Address: | 14 Blue Herron Rd Dudley, MA - 015716035 |
Business Phone Number: | 5084989907 |
Business Fax Number: | |
Mailing Address: | 14 Blue Herron Rd, DUDLEY |
State: | MA |
Postal Code: | 015716035 |
Phone Number: | 5084989907 |
Fax Number: | |
NPI Enumeration Date: | 03/24/2010 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |