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NPI Code Detail

MEDICARE: BONNY RYE LLP

MEDICARE: BONNY RYE LLP
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
1103T00000XPsychologist6361002652MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932752235
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNY RYE LLP
Provider Business Mailing Address
First Line : 4060 SPRINGER WAY APT 1824
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-8340
Country : US
Telephone Number : 810-441-1873
Fax Number :
Provider Business Practice Location Address
First Line : 4690 FULTON ST E STE 102
Second Line :
City : ADA
State : MI
Zip : 49301-8454
Country : US
Telephone Number : 616-425-7701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2019
Last Update Date : 09/15/2025

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Directions to “ BONNY RYE LLP” Practice Location

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