Katherine D Bolls

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bossier City, LA

NPI 1225601719 · NPPES record last updated Jul 21, 2021

Key facts

NPI
1225601719
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CIT5326 (LA)
Practice address
1505 Doctors Dr
Bossier City, LA 71111-3321
Phone
(318) 584-7133
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CIT5326LAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CIT5326 LA Yes

Addresses

Primary practice location

1505 Doctors Dr
Bossier City, LA 71111-3321

Mailing address

1505 Doctors Dr
Bossier City, LA 71111-3321
Phone (318) 584-7133

Other providers in Bossier City, LA

All providers in Bossier City, LA · Addiction (Substance Use Disorder) Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.