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General NPI Number Information
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NPI Number | 1265559702
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Entity Type | Organization
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Legal Business Name | AKBOLTON PLLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 2242 W JEFFERSON AVE STE A
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City | TRENTON
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State | MI
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Zip | 48183-2275
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Country | US
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Telephone | 734-250-3919
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Fax |
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Provider Business Mailing Address
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Address Line | 2242 W JEFFERSON AVE STE A
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City | TRENTON
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State | MI
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Zip | 48183-2275
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Country | US
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Telephone | 734-250-3919
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AMY K. BOLTON
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Credential | MA, LLP
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Telephone | 734-250-3919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301011716
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License Number State | MI
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