Individual
MS. MELODY BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
1918 HOPEWELL ST APT A, UNIT A, SANTA FE, NM 87505-3857
(505) 992-8900
Mailing address
PO BOX 6338, SANTA FE, NM 87502-6338
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0077101
NM
Other
Enumeration date
06/24/2006
Last updated
07/08/2007
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