Individual
DR. JUSTIN BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2100 S TRIVIZ DR STE G, LAS CRUCES, NM 88001-0601
(575) 556-1849
(575) 532-2030
Mailing address
4577 NORTHWIND RD, LAS CRUCES, NM 88007-4531
(650) 303-9102
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1429
NM
Other
Enumeration date
07/20/2017
Last updated
08/11/2019
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