| NPI | 1235318809 |
|---|---|
| Former Name | JANA MARIE BOLDUAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0004X Psychologist Health (Licence: CO 3145) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 3145) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CO 3145) | |
| 103TC0700X Psychologist Clinical (Licence: CO 3145) | |
| 103TC1900X Psychologist Counseling (Licence: CO 3145) | |
| 103TH0100X Psychologist Health Service (Licence: CO 3145) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CO 3145) | |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-31 |