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Individual

KAREN BOLLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.H.D.

Contact information

Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-5624
Mailing address
PO BOX 64227, BALTIMORE, MD 21264-4227

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01926
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
633602700
MD
Enumeration date
04/27/2006
Last updated
11/24/2009
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