| Organization Name: | SUSAN G. BOLEY, PH.D. P.C. |
| NPI Number: | 1023354057 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN BOLEY (DIRECTOR) |
| Mailing Address: | 11 W Dry Creek Cir Suite 140 Littleton |
| State: | CO US |
| Postal Code: | 801208077 |
| Phone Number: | 3037947761 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2012 |
| NPI Last Update Date: | 12/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2224 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |