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1992868715
ANITA DIANE BOLIN
PADUCAH, KY
NPI
1992868715
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center)
Enumeration Date
2006-12-19
Last Update Date
2009-02-24
Business Address
ANITA DIANE BOLIN
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number: 270-442-7121
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Mailing Address
ANITA DIANE BOLIN
425 BROADWAY
PADUCAH, KY 42001
Phone number:
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