Individual
LARRY A BOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
111 S WHITTIER ST, SUITE 305, WICHITA, KS 67207-1048
(316) 689-4220
(316) 689-4221
Mailing address
111 S WHITTIER ST, SUITE 305, WICHITA, KS 67207-1048
(316) 689-4220
(316) 689-4221
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
288
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007049
BC/BS
KS
Enumeration date
08/30/2006
Last updated
07/08/2007
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