NPI 1043613516

Jessica Lorena Bonilla

Practitioner Health & Wellness Coach Smithtown, NY

Practice location

Address: 156 Landing Meadow Rd, Smithtown, NY 11787-1100
Phone: (631) 626-6377

Registered specialties (2)

Health & Wellness Coach Primary

Other Service Providers Taxonomy 171400000X

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Speech-Language Pathologist

Speech, Language and Hearing Service Providers Taxonomy 235Z00000X Licence 07643 (MD)

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Registry record

NPI: 1043613516
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Sep 2014
Record last updated: 5 May 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.