Michelle Bonifas
Individual provider Active NPI School Psychologist · Piqua, OH
NPI 1508784257 · NPPES record last updated Jul 9, 2026
Key facts
- NPI
- 1508784257
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 00458 (OH)
- Practice address
- 145 E US Hwy 36
Piqua, OH 45356-8201 - Phone
- (937) 773-4321
- Fax
- (937) 778-4517
- NPI assigned
- Jul 9, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 00458 | OH | Yes |
Addresses
Primary practice location
145 E US Hwy 36
Piqua, OH 45356-8201
Mailing address
625 Pinehurst Dr
Tipp City, OH 45371-8603
Phone (937) 773-4321
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00458 | Other | OH | STATE LICENSING BOARD |
Other providers in Piqua, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.