Individual
KAYLA BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7012 LAKE RD, WOODBURY, MN 55125-2433
(651) 287-9529
Mailing address
1740 BLUEWATER LN, WOODBURY, MN 55129-6236
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201795
MN
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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