Doctor Name: | ELISA ESTHERA BOLTON |
NPI Number: | 1124210232 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1091 |
Business Practice Address: | 304 Pioneer Rd Rye, NH - 038702128 |
Business Phone Number: | 6034302884 |
Business Fax Number: | |
Mailing Address: | 304 Pioneer Rd, RYE |
State: | NH |
Postal Code: | 038702128 |
Phone Number: | 6034302884 |
Fax Number: | |
NPI Enumeration Date: | 08/13/2007 |
NPI Last Update Date: | 09/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1091 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |