Most Relevant Information
Provider Data
| NPI Number: | 1003483611 |
| Provider Name: | JACQUELINE R BONARDI |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/10/2021 |
| Last Updated: | 06/10/2021 |
Provider Practice Location
1485 M 139
BENTON HARBOR
MI
490225711
Practice Location Phone/Fax
| Phone: | 2699250585 |
| Fax: | 2699271326 |
Provider Mailing Location
1485 M 139
BENTON HARBOR
MI
490225711
Provider Mailing Phone/Fax
| Phone: | 2699250585 |
| Fax: | 2699271326 |