Doctor Name: | MEGAN B BOLCH |
NPI Number: | 1003914219 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 1360 |
Business Practice Address: | 12330 Metcalf Ave Suite 300 Overland Park, KS - 662131324 |
Business Phone Number: | 9139060900 |
Business Fax Number: | 9139060909 |
Mailing Address: | 12330 Metcalf Ave, Suite 300 OVERLAND PARK |
State: | KS |
Postal Code: | 662131324 |
Phone Number: | 9139060900 |
Fax Number: | 9139060909 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 1360 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |