Individual
TONYA ANNE BOLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
482 BLACK RIVER PKWY, WATERTOWN, NY 13601-2416
(315) 782-1777
(315) 782-8628
Mailing address
482 BLACK RIVER PKWY, WATERTOWN, NY 13601-2416
(315) 782-1777
(315) 782-8628
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
578776
NY
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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