Individual
BENJAMIN J. BOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 W LAS CRUCES AVE, LAS CRUCES, NM 88005-1804
(575) 249-0390
Mailing address
7012 RAASAF DR, LAS CRUCES, NM 88005-4621
(575) 649-9275
(575) 267-6228
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NM
171W00000X
Contractor
Primary
—
NM
172V00000X
Community Health Worker
—
NM
Other
Enumeration date
09/30/2021
Last updated
01/19/2026
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