| Doctor Name: | NAOMI BOLEY |
| NPI Number: | 1316305055 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 001947843 |
| Business Practice Address: | 763 Caffee Rd Dahlgren, VA - 224483030 |
| Business Phone Number: | 7578464162 |
| Business Fax Number: | 5406441020 |
| Mailing Address: | 491 Lee Boutwell Rd, WINNSBORO |
| State: | LA |
| Postal Code: | 712955152 |
| Phone Number: | 3182825358 |
| Fax Number: | 5406441020 |
| NPI Enumeration Date: | 02/09/2016 |
| NPI Last Update Date: | 02/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 172A00000X |
| License Number: | 001947843 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Driver |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |