Individual
CONNIE J BOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
600 MONUMENT ST, SUITE 224, GREENWOOD, SC 29646-2638
(864) 227-3908
(864) 227-2668
Mailing address
600 MONUMENT ST, SUITE 224, GREENWOOD, SC 29646-2638
(864) 227-3908
(864) 227-2668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6275
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
QM0429
—
SC
Enumeration date
07/03/2006
Last updated
12/03/2007
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