Individual
BARBARA MYERS BOLDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
624 S AUSTIN AVE, STE 220, GEORGETOWN, TX 78626-5707
(512) 869-1152
(512) 869-1145
Mailing address
624 S AUSTIN AVE, STE 220, GEORGETOWN, TX 78626-5707
(512) 869-1152
(512) 869-1145
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
455585
VALUE OPTIONS PROVIDER #
TX
01
—
8403BH
BCBS PROVIDER NUMBER
TX
Enumeration date
02/21/2007
Last updated
07/08/2007
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