Organization
BOLTE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA R. BOLTE PH.D. (DIRECTOR)
(859) 426-0200
Entity
Organization
Contact information
Practice address
305 ARTILLERY PARK DR, SUITE 102, FORT MITCHELL, KY 41017-2781
(859) 426-0200
(859) 426-0042
Mailing address
305 ARTILLERY PARK DR, SUITE 102, FORT MITCHELL, KY 41017-2781
(859) 426-0200
(859) 426-0042
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1298
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366493298
NPI TYPE 1
KY
Enumeration date
11/19/2012
Last updated
11/19/2012
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