Individual
NEAL BOLIOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHY.D.
Contact information
Practice address
1327 S FIVE MILE RD, BOISE, ID 83709-1306
(208) 375-7777
(208) 445-5899
Mailing address
1327 S FIVE MILE RD, BOISE, ID 83709-1306
(208) 375-7777
(208) 375-7598
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-247
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016161
REGENCE BLUE SHIELD OF ID
ID
01
—
N9998
BLUE CROSS OF IDAHO
ID
Enumeration date
01/28/2007
Last updated
08/08/2017
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