Individual
DR. JOHN P BOLGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1305 WILD OLIVE DR, MT PLEASANT, SC 29464-7478
(910) 987-7285
Mailing address
1305 WILD OLIVE DR, MT PLEASANT, SC 29464-7478
(910) 987-7285
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4800
OH
103TA0700X
Adult Development & Aging Psychologist
4800
OH
103TC0700X
Clinical Psychologist
4800
OH
103TH0004X
Health Psychologist
4800
OH
103TR0400X
Rehabilitation Psychologist
4800
OH
Other
Enumeration date
07/04/2006
Last updated
04/04/2019
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