Individual
DR. ROSEANNE MARIE BOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
211 ROBERT PARKER COFFIN RD, LONG GROVE, IL 60047
(847) 821-1459
(847) 359-7673
Mailing address
211 ROBERT PARKER COFFIN RD, LONG GROVE, IL 60047
(847) 821-1459
(847) 359-7673
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004907383
BCBS
IL
Enumeration date
09/26/2006
Last updated
07/08/2007
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