Dr. John P Bolger, Ph.D.
Clinical Neuropsychologist in Mt Pleasant, SC. Individual provider (NPI-1).
NPI number1891725024
StatusActive
Last updated in NPPESApr 4, 2019
Details
- NPI
- 1891725024
- Entity type
- Individual (NPI-1)
- Name
- Dr. John P Bolger
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 4, 2006
- Last updated
- Apr 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 4800 | OH | Yes |
| 103TA0700X | Psychologist, Adult Development & Aging | 4800 | OH | |
| 103TC0700X | Psychologist, Clinical | 4800 | OH | |
| 103TH0004X | Psychologist, Health | 4800 | OH | |
| 103TR0400X | Psychologist, Rehabilitation | 4800 | OH |
Practice location
1305 Wild Olive DrMt Pleasant, SC 29464-7478
Phone 910-987-7285
Mailing address
1305 Wild Olive DrMt Pleasant, SC 29464-7478
Phone 910-987-7285
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