Individual
MRS. AMANDA JANE BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LGPC
Contact information
Practice address
1804 LARKIN PL, BEL AIR, MD 21015-4885
(443) 910-0612
Mailing address
900 S MAIN ST BLDG A, BEL AIR, MD 21014-5447
(410) 914-4012
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC4827
MD
101YP2500X
Professional Counselor
LGP3491
MD
Other
Enumeration date
04/19/2012
Last updated
08/06/2020
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