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Individual

MS. MICHELLE BOLTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC-S

Contact information

Practice address
14368 HIGHWAY 43 STE 1, RUSSELLVILLE, AL 35653-2569
(256) 291-7221
Mailing address
1007 HIGHWAY 175, PHIL CAMPBELL, AL 35581-5859
(847) 769-1090

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.005944
IL
101YP2500X
Professional Counselor
180007883
IL
101YP2500X
Professional Counselor
Primary
3503
AL

Other

Enumeration date
04/30/2009
Last updated
08/10/2021
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