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General NPI Number Information
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NPI Number | 1598305542
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Entity Type | Individual
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Provider Name | KAYLI MARIE BONENFANT M.ED
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 1635 MINERAL SPRING AVE STE 206
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-4025
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Country | US
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Telephone | 401-786-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 33 CRESCENT AVE
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City | RIVERSIDE
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State | RI
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Zip | 02915-5411
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Country | US
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Telephone | 774-503-9488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LABA3395
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 002618
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA00475
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License Number State | RI
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