DR. Nelly Esther Bonilla Bonilla, PSYD, LP

NPI #1356830210 in Jordan, Minnesota

Provider Information

NPI Number: 1356830210
Entity Type: Individual
Name: DR. Nelly Esther Bonilla Bonilla, PSYD, LP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist
Credential: PSYD, LP
Enumeration Date: May 7, 2018
Last Updated: Sep 19, 2024

Practice Location

Address: 863 FOREST EDGE DR
City: Jordan
State: Minnesota
ZIP Code: 55352-4502
Phone: (612) 475-0505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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