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Individual

CHELSE BOLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3400 1ST ST N STE 101, SAINT CLOUD, MN 56303-1924
(612) 268-5858
Mailing address
7401 METRO BLVD STE 250, EDINA, MN 55439-3062
(612) 268-5858

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1041C0700X
Clinical Social Worker
23169
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23169
LICSW LICENSE
MN
Enumeration date
03/10/2022
Last updated
10/09/2024
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