Individual
EDWARD PAUL BOLINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PCC
Contact information
Practice address
318 MAHONING AVE NW, WARREN, OH 44483-4605
(330) 395-9563
Mailing address
501 BUTLER RD NE, WARREN, OH 44483-5607
(330) 372-6782
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0000680
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000001254229
ANTHEM
OH
Enumeration date
02/05/2007
Last updated
07/08/2007
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