Provider Demographics
NPI:1760623367
Name:BONILLA, CYNTHIA Y (SLPA)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:Y
Last Name:BONILLA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 N MAIN ST
Mailing Address - Street 2:APT. 36
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4636
Mailing Address - Country:US
Mailing Address - Phone:956-664-9904
Mailing Address - Fax:956-664-9879
Practice Address - Street 1:801 E. NOLANA AVE
Practice Address - Street 2:STE 10
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6112
Practice Address - Country:US
Practice Address - Phone:956-664-9904
Practice Address - Fax:956-664-9879
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX348202355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant