Individual
MS. BETINA LYNN BOLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2707 BROWNS LN, JONESBORO, AR 72401
(870) 972-4939
(870) 972-4911
Mailing address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2002009971
MO
1041C0700X
Clinical Social Worker
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639407588
MEDICARE CMS
MO
05
—
1639407588
—
MO
Enumeration date
12/03/2009
Last updated
01/07/2019
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