Individual
DR. KELLY MINNETTE BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1 CHILDRENS PL # 3N14, SAINT LOUIS, MO 63110-1081
(314) 454-6069
Mailing address
1 CHILDRENS PL # 3N14, SAINT LOUIS, MO 63110-1081
(314) 454-6069
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
MO
Other
Enumeration date
07/26/2022
Last updated
08/10/2023
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