Provider Demographics
NPI:1366063745
Name:BONO, AIMEE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:MARIE
Last Name:BONO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W 75TH ST STE 117
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2241
Mailing Address - Country:US
Mailing Address - Phone:806-217-0902
Mailing Address - Fax:
Practice Address - Street 1:10000 W 75TH ST STE 117
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2241
Practice Address - Country:US
Practice Address - Phone:816-898-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSBL19-3741225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist