Individual
ANTONIA LYNN BOLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
409 CENTER RD APT 3, BEDFORD HTS, OH 44146-2262
(216) 854-5969
Mailing address
409 CENTER RD APT 3, BEDFORD HTS, OH 44146-2262
(216) 854-5969
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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