Ileana Maria Bonanno

NPI #1982355947 in South Boston, Massachusetts

Provider Information

NPI Number: 1982355947
Entity Type: Individual
Name: Ileana Maria Bonanno
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 11, 2022
Last Updated: Jan 11, 2022

Practice Location

Address: 871 E BROADWAY APT 3
City: South Boston
State: Massachusetts
ZIP Code: 02127-2322
Phone: (984) 289-7977

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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