Individual
AUGUSTA BOLWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
540 S EREMLAND DR, COVINA, CA 91723-3186
(262) 966-1577
Mailing address
540 S EREMLAND DR, COVINA, CA 91723-3186
(262) 966-1577
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/28/2015
Last updated
07/21/2022
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