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NPI Code Detail

MEDICARE: JODI BONELLA

MEDICARE: JODI BONELLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1568836443
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODI BONELLA
Provider Business Mailing Address
First Line : 6013 S REDWOOD RD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84123-5220
Country : US
Telephone Number : 801-255-5131
Fax Number : 801-255-5131
Provider Business Practice Location Address
First Line : 6013 S REDWOOD RD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84123-5220
Country : US
Telephone Number : 801-255-5131
Fax Number : 801-255-5131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2015
Last Update Date : 11/16/2015

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Directions to “ JODI BONELLA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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