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General NPI Number Information
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NPI Number | 1639750631
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Entity Type | Individual
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Provider Name | ALESSANDRA BONILLA M.S, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 1515 HERITAGE DR STE 105
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City | MCKINNEY
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State | TX
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Zip | 75069-3378
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Country | US
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Telephone | 469-963-3561
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Fax |
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Provider Business Mailing Address
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Address Line | 680 EXECUTIVE DR APT 5308
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City | PLANO
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State | TX
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Zip | 75074-0263
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Country | US
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Telephone | 786-340-9693
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 85717
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License Number State | TX
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