| Lisa Bolhouse | |
|
109 W 4th Ave Tallahassee FL 32303-6152 | |
| (850) 443-8977 | |
| (850) 765-5487 |
| Full Name | Lisa Bolhouse |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 109 W 4th Ave, Tallahassee, Florida |
| Authorized Official Name and Position | Lisa Marie Bolhouse (OWNER, PRIVATE PRACTICE) |
| Authorized Official Contact | 8504438977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Bolhouse 4996 Branded Oaks Ct Tallahassee FL 32311-8834 Ph: (850) 443-8977 | Lisa Bolhouse 109 W 4th Ave Tallahassee FL 32303-6152 Ph: (850) 443-8977 |
| NPI Number | 1396125514 |
|---|---|
| Provider Enumeration Date | 06/03/2015 |
| Last Update Date | 06/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396125514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW1872 (Florida) | Primary |
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