Individual
KRISTI BOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12536
SC
1041C0700X
Clinical Social Worker
Primary
16676
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3335
MEDICARE
SC
05
—
421504
—
SC
Enumeration date
05/02/2014
Last updated
05/19/2025
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