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Individual

COURTNEY BOLLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
839 21ST ST SE, CEDAR RAPIDS, IA 52403-2718
(785) 210-6287
Mailing address
839 21ST ST SE, CEDAR RAPIDS, IA 52403-2718
(785) 210-6287

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
10076A
NC
106H00000X
Marriage & Family Therapist
Primary
128393
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093949109
NC
Enumeration date
08/14/2015
Last updated
05/22/2025
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