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Individual
MR. CHRISTOPHER GEORGE BOLLER
Active
Individual
MR. CHRISTOPHER GEORGE BOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
072771-1
NY
1041C0700X
Clinical Social Worker
Primary
072771-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00072771
—
NY
01
—
072771-1
LCSW
NY
Enumeration date
01/24/2007
Last updated
08/24/2009
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