Individual
MS. LISA DIANE BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LSW
Contact information
Practice address
408 8TH ST, NEW KENSINGTON, PA 15068-6426
(724) 339-6860
(724) 339-5584
Mailing address
408 8TH ST, NEW KENSINGTON, PA 15068-6426
(724) 339-6860
(724) 339-5584
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW129033
PA
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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