Individual
ELIZABETH LARKIN BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSMFT
Contact information
Practice address
3995 MARCOLA RD, SPRINGFIELD, OR 97477-7948
(541) 747-7734
Mailing address
701 N 5TH ST, P1123, LEBANON, OR 97355-9559
(847) 254-1663
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/29/2011
Last updated
11/18/2012
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