Healthcare Provider Details

I. General information

NPI: 1528596871
Provider Name (Legal Business Name): CHRISTINA JOY BONNIWELL MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 CENTRAL AVE
MIDDLETOWN OH
45044-4934
US

IV. Provider business mailing address

PO BOX 131
MIDDLETOWN OH
45042-0131
US

V. Phone/Fax

Practice location:
  • Phone: 513-805-1016
  • Fax:
Mailing address:
  • Phone: 513-752-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF.2600609
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: