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General NPI Number Information
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NPI Number | 1083017529
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Entity Type | Individual
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Provider Name | DONIQUE BOLAR BCBA
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Gender | Male
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 3098 PIEDMONT RD NE STE 200
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City | ATLANTA
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State | GA
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Zip | 30305-2600
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Country | US
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Telephone | 561-210-3264
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Fax | 561-210-5500
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Provider Business Mailing Address
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Address Line | 542 AMHERST ST STE B
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City | NASHUA
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State | NH
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Zip | 03063-1016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2021-032
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-49013
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License Number State | GA
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