| Doctor Name: | DR. JOSEPH CALVIN BOLTON |
| NPI Number: | 1063698710 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 1047 |
| Business Practice Address: | 4863a Main St Zachary, LA - 707913943 |
| Business Phone Number: | 2256542357 |
| Business Fax Number: | 2256541192 |
| Mailing Address: | Po Box 86, ZACHARY |
| State: | LA |
| Postal Code: | 707910086 |
| Phone Number: | 2256542357 |
| Fax Number: | 2256541192 |
| NPI Enumeration Date: | 01/11/2008 |
| NPI Last Update Date: | 01/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1047 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |