Individual
MS. MARY KATHLEEN BOLLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3705 MEDICAL PARKWAY, #450, AUSTIN MEDICAL PLAZA, AUSTIN, TX 78705
(512) 306-0061
(512) 306-0069
Mailing address
3705 MEDICAL PARKWAY #450, AUSTIN MEDICAL PLAZA, AUSTIN, TX 78705
(512) 306-0061
(512) 306-0069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13337
TX
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
521247
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
521247
TX
Other
Enumeration date
08/08/2006
Last updated
10/28/2015
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