Individual
LIANA BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 SAGE LN, LEBANON, ME 04027-3863
(214) 770-1306
Mailing address
29 SAGE LN, LEBANON, ME 04027-3863
(214) 770-1306
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31079
ME
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
09/03/2014
Last updated
10/30/2024
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