Individual
DR. WALTER C BUBOLTZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
622 BURGESSVILLE RD, RUSTON, LA 71270-5154
(318) 224-7223
(318) 415-1004
Mailing address
2101 WALNUT AVE, RUSTON, LA 71270-5145
(318) 512-9637
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
870
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3823004
—
LA
Enumeration date
07/15/2013
Last updated
04/29/2026
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