Mary Kathleen Bolles, PMHNP
Nurse Practitioner, Psych/Mental Health in Austin, TX. Individual provider (NPI-1).
NPI number1124037957
StatusActive
Last updated in NPPESOct 28, 2015
Details
- NPI
- 1124037957
- Entity type
- Individual (NPI-1)
- Name
- Ms. Mary Kathleen Bolles
- Credential
- PMHNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 8, 2006
- Last updated
- Oct 28, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 521247 | TX | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 13337 | TX | |
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 521247 | TX |
Practice location
3705 Medical Parkway, #450Austin Medical Plaza
Austin, TX 78705
Phone 512-306-0061 · Fax 512-306-0069
Mailing address
3705 Medical Parkway #450Austin Medical Plaza
Austin, TX 78705
Phone 512-306-0061 · Fax 512-306-0069
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