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General NPI Number Information
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NPI Number | 1205439353
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Entity Type | Individual
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Provider Name | KATIE YAMAKI BOLAND TLMFT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 523 1/2 COURT ST.
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City | WILLIAMSBURG
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State | IA
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Zip | 52361
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Country | US
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Telephone | 319-600-1217
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Fax |
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Provider Business Mailing Address
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Address Line | 170 MCKENZIE LN S
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9172
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Country | US
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Telephone | 319-621-2985
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 098164
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License Number State | IA
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