Individual
MS. KATHY J BOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2200 FORT ROOTS DR, 122/A, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-1000
Mailing address
2200 FORT ROOTS DR, 122/A, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
739-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041C0700X
CLINICAL SOCIAL WORKER
AR
Enumeration date
10/03/2006
Last updated
07/08/2007
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