Individual
BRYAN L BOLWAHNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, M.P.
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
926MPAP
LA
Other
Enumeration date
06/26/2006
Last updated
10/09/2013
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