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Individual
MRS. SHOJI MARY BOLDT
Active
Individual
MRS. SHOJI MARY BOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.004697
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437470234
NPI TYPE 2
IL
Enumeration date
09/18/2007
Last updated
06/15/2010
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