Individual
JACKIE BOLING
Active
Individual
JACKIE BOLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
104821
TX
1041C0700X
Clinical Social Worker
Primary
16719
LA
1041C0700X
Clinical Social Worker
CSW.09926683
CO
Other
Enumeration date
01/23/2017
Last updated
08/09/2022
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