Organization
LISA BOLHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARIE BOLHOUSE LCSW (OWNER, PRIVATE PRACTICE)
(850) 443-8977
Entity
Organization
Contact information
Practice address
109 W 4TH AVE, TALLAHASSEE, FL 32303-6152
(850) 443-8977
(850) 765-5487
Mailing address
4996 BRANDED OAKS CT, TALLAHASSEE, FL 32311-8834
(850) 443-8977
(850) 765-5487
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW1872
FL
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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