Healthcare Provider Details

I. General information

NPI: 1326656588
Provider Name (Legal Business Name): CYNTHIA BONIFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1198 S GOVERNORS AVE STE 201
DOVER DE
19904-6930
US

IV. Provider business mailing address

1198 S GOVERNORS AVE STE 201
DOVER DE
19904-6930
US

V. Phone/Fax

Practice location:
  • Phone: 302-382-8698
  • Fax: 302-269-3800
Mailing address:
  • Phone: 302-382-8698
  • Fax: 302-269-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0011870
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: