| NPI | 1104020098 |
|---|---|
| Former Name | ERICA OPAL BOLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 57303) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AL 2337G) |
| 101Y00000X Counselor (Licence: AL 2337G) | |
| 1041C0700X Social Worker Clinical (Licence: AL 2248C) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2017-05-01 |