Individual
LORRIE ANN BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
200 ELIZABETH ST, CHARLESTON, WV 25311-2119
(304) 348-7740
Mailing address
19 BARBARA AVE, MC DERMOTT, OH 45652-9046
(740) 259-5176
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1033
WV
224Z00000X
Occupational Therapy Assistant
OTA-00775
OH
Other
Enumeration date
09/23/2006
Last updated
07/08/2007
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