Tammy M Bolles, LCSW
Social Worker, Clinical in Chuluota, FL. Individual provider (NPI-1).
NPI number1669980439
StatusActive
Last updated in NPPESJan 16, 2018
Details
- NPI
- 1669980439
- Entity type
- Individual (NPI-1)
- Name
- Tammy M Bolles
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 16, 2018
- Last updated
- Jan 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | SW13585 | FL | Yes |
Practice location
1708 Old River Trl.Chuluota, FL 32766-3276
Phone 305-781-1682 · Fax 305-781-1682
Mailing address
1708 Old River TrlChuluota, FL 32766-8603
Phone 305-781-1682
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