Doctor Name: | MATTHEW BOLAND |
NPI Number: | 1013342831 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 505 S Arlington Ave Suite 212-c Reno, NV - 895091527 |
Business Phone Number: | 7752009665 |
Business Fax Number: | |
Mailing Address: | 505 S Arlington Ave, Suite 212-c RENO |
State: | NV |
Postal Code: | 895091527 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/11/2013 |
NPI Last Update Date: | 09/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |