Provider Demographics
NPI:1760526404
Name:BONILLARODRIGUEZ, REGINA JOYITA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:JOYITA
Last Name:BONILLARODRIGUEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2150 E TREMONT AVE
Mailing Address - Street 2:MC
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-5758
Mailing Address - Country:US
Mailing Address - Phone:646-387-3711
Mailing Address - Fax:718-892-0152
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:7B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5000
Practice Address - Fax:718-579-5045
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY002356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health