| NPI | 1861797805 |
|---|---|
| Other Name | KELLY BOLINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043413) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2020-11-16 |