LARA JEAN BOLSOM

FRESH MEADOWS, NY
NPI1437461985
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NY  084269-1)
Enumeration Date2010-07-12
Last Update Date2017-03-01
Business Address
-- LARA JEAN BOLSOM LCSW
6143 186TH ST
FRESH MEADOWS, NY 11365-2710
Phone number: 347-921-4019
Mailing Address
-- LARA JEAN BOLSOM LCSW
6143 186TH ST
FRESH MEADOWS, NY 11365-2710
Phone number: 347-921-4019
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