Individual
LINDSAY BOLTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
123 S MAIN ST, ATHOL, MA 01331-2131
(855) 295-3276
(818) 241-6853
Mailing address
505 N BRAND BLVD, #1000, GLENDALE, CA 91203-1906
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8788
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-11-8788
BCBA
MA
Enumeration date
12/19/2013
Last updated
12/19/2013
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