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General NPI Number Information
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NPI Number | 1932253218
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Entity Type | Individual
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Provider Name | BONNIE CHRISTINE MIRIANI LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1701 LAKE LANSING RD STE 120
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City | LANSING
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State | MI
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Zip | 48912
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Country | US
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Telephone | 810-494-7180
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Fax | 810-215-1334
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Provider Business Mailing Address
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Address Line | 1033 HEALTHCARE DR
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City | CHARLOTTE
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State | MI
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Zip | 48813-1058
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Country | US
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Telephone | 517-541-2673
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Fax | 517-543-2656
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801082008
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License Number State | MI
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