Doctor Name: | JAMES T BOLIN |
NPI Number: | 1396021747 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW, LCSW |
License Number: | 1396 |
Business Practice Address: | 6000 Kanakanak Rd Bristol Bay Area Health Corporation Dillingham, AK - 995760130 |
Business Phone Number: | 9078421230 |
Business Fax Number: | |
Mailing Address: | 6000 Kanakanak Rd, Bristol Bay Area Health Corporation DILLINGHAM |
State: | AK |
Postal Code: | 995760130 |
Phone Number: | 9078421230 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2011 |
NPI Last Update Date: | 06/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1396 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |