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1457903031
LISA BOLMAN
GULFPORT, MS
NPI
1457903031
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MS 4143)
Enumeration Date
2019-07-12
Last Update Date
2019-07-12
Business Address
LISA BOLMAN PCMHT
1600 BROAD AVE
GULFPORT, MS 39501-3603
Phone number: 228-863-1132
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Mailing Address
LISA BOLMAN PCMHT
1600 BROAD AVE
GULFPORT, MS 39501-3603
Phone number: 228-863-1132
Copy
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