Individual
MORGAN BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4250 PLYMOUTH RD, ANN ARBOR, MI 48109-2700
(734) 764-0231
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301019022
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
OR
Enumeration date
08/22/2016
Last updated
01/30/2023
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