| Organization Name: | BOLTE PSYCHOLOGICAL SERVICES, LLC |
| NPI Number: | 1245574912 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA R. BOLTE (DIRECTOR) |
| Mailing Address: | 305 Artillery Park Dr Suite 102 Fort Mitchell |
| State: | KY US |
| Postal Code: | 410172781 |
| Phone Number: | 8594260200 |
| Fax Number: | 8594260042 |
| NPI Enumeration Date: | 11/19/2012 |
| NPI Last Update Date: | 11/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1298 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |