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JOHN EDWARD BOLDING LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1902284979

Individual Registrant:
 JOHN EDWARD BOLDING LCSW
Gender: M
Not Sole Proprietor

Location and contact information for practice:
790 ROBERTS DR  MONTICELLO, AR 71655-5723 US
Tel: 708-226-5856  Fax: --

Contact information for business:
790 ROBERTS DR  MONTICELLO, AR 71655-5723 US
Tel: 708-226-5856  Fax: --

Registration Information:
NPI: 1902284979
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
AR7556-M

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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