Individual
COLLEEN BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5415 BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 941-1910
Mailing address
5415 BACKLICK RD, SPRINGFIELD, VA 22151-3915
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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