Individual
KEVIN R. BOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
300 E 6TH ST, TEXARKANA, AR 71854-5207
(870) 772-0156
Mailing address
4560 FM 995, ATLANTA, TX 75551-6412
(903) 733-2743
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
80934
TX
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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