Individual
DR. KRYSTEN BOLD
Active
Individual
DR. KRYSTEN BOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
003619
CT
103TC0700X
Clinical Psychologist
Primary
003619
CT
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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