Individual
AMANDA MICHELE BOLTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
900 S DEER RD, MACOMB, IL 61455-2639
(309) 837-4876
(309) 833-1531
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-2323
(309) 344-4368
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29487
IL
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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