Organization
MARY KATHLEEN BOLLES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHLEEN BOLLES PMHNP (OWNER)
(512) 739-6566
Entity
Organization
Contact information
Practice address
5000 BEE CAVES RD STE 106, WEST LAKE HILLS, TX 78746-5254
(512) 791-5433
Mailing address
6714 LA CONCHA PASS, AUSTIN, TX 78749-1716
(512) 791-5433
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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