Individual
DORENE M BOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4575 8TH DIVISION RD, FT JACKSON, SC 29207
(803) 751-5911
Mailing address
4575 8TH DIVISION RD, FT JACKSON, SC 29207
(803) 751-5911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7723
SC
1041C0700X
Clinical Social Worker
CSW003589
GA
Other
Enumeration date
03/14/2008
Last updated
02/14/2025
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