Marissa D Bolles

NPI #1215501952 in Columbus, Ohio

Provider Information

NPI Number: 1215501952
Entity Type: Individual
Name: Marissa D Bolles
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: May 17, 2021
Last Updated: May 17, 2021

Practice Location

Address: 3070 RIVERSIDE DR
City: Columbus
State: Ohio
ZIP Code: 43221-2547
Phone: (866) 523-4268

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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