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Individual
BETTY BOLTE
Active
Individual
BETTY BOLTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP, LCAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
476
KS
103T00000X
Psychologist
0517
KS
103T00000X
Psychologist
Primary
904
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11658758
CAQH
—
05
—
200440980A
—
KS
01
—
856659
BCBS
KS
Enumeration date
06/09/2006
Last updated
02/06/2019
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