Individual
DR. JEANNE M. BOLTON
Active
Individual
DR. JEANNE M. BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
1855
MD
103TC0700X
Clinical Psychologist
Primary
1855
MD
103TC2200X
Clinical Child & Adolescent Psychologist
1855
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-17562656
EIN
MD
01
—
235733
MDIPA PROVIDER #
MD
Enumeration date
04/24/2007
Last updated
10/25/2010
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