Doctor Name: | MISS BRIDGET ANN BOLEY |
NPI Number: | 1013271758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 2014015191 |
Business Practice Address: | 402 S Silver Springs Rd Cape Girardeau, MO - 637037536 |
Business Phone Number: | 5733341100 |
Business Fax Number: | 5736514345 |
Mailing Address: | 402 S Silver Springs Rd, CAPE GIRARDEAU |
State: | MO |
Postal Code: | 637037536 |
Phone Number: | 5733341100 |
Fax Number: | 5736514345 |
NPI Enumeration Date: | 06/27/2012 |
NPI Last Update Date: | 07/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2014015191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |