Doctor Name: | MS. SHARON ELISABETH BOLLES |
NPI Number: | 1417250770 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.P.C. |
License Number: | C0908 |
Business Practice Address: | 1134 Anderson Creek Rd Talent, OR - 975407748 |
Business Phone Number: | 5418405922 |
Business Fax Number: | |
Mailing Address: | 1136 Anderson Creek Rd, TALENT |
State: | OR |
Postal Code: | 975407748 |
Phone Number: | 5418405922 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2010 |
NPI Last Update Date: | 02/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C0908 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |