Individual
LANNY CLARICE BOLLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
101 MED TECH PKWY STE 200, JOHNSON CITY, TN 37604-4001
(423) 232-6120
(423) 232-6125
Mailing address
108 W SUMMIT HILL DR, KNOXVILLE, TN 37902-1025
(865) 525-1099
(865) 525-7494
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P2824
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I681458
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
TN
Enumeration date
03/14/2007
Last updated
07/20/2023
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