Mark Bolton

NPI #1164128625 in Cape Canaveral, Florida

Provider Information

NPI Number: 1164128625
Entity Type: Individual
Name: Mark Bolton
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Enumeration Date: Feb 6, 2023
Last Updated: Feb 6, 2023

Practice Location

Address: 549 TAYLOR AVE
City: Cape Canaveral
State: Florida
ZIP Code: 32920-5204
Phone: (313) 258-4137

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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Organizations

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