Organization
BUBOLTZ & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER BUBOLTZ PHD (PSYCHOLOGIST)
(318) 512-9637
Entity
Organization
Contact information
Practice address
2101 WALNUT AVE, RUSTON, LA 71270-5145
(318) 512-9637
Mailing address
2101 WALNUT AVE, RUSTON, LA 71270-5145
(318) 512-9637
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
870
LA
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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