Dr. Dianna W Bolen, Psyd
Psychologist, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1417089293
StatusActive
Last updated in NPPESJun 29, 2009
Details
- NPI
- 1417089293
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dianna W Bolen
- Credential
- Psyd
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 9, 2007
- Last updated
- Jun 29, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 071006419 | IL | Yes |
Practice location
4350 N Hermitage AveChicago, IL 60613-1106
Phone 773-327-9356 · Fax 773-348-8220
Mailing address
4350 N Hermitage AveChicago, IL 60613-1106
Phone 773-327-9356 · Fax 773-348-8220
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