=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326906785
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MCKENNA GRACE BOLING BA, CT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2026
-----------------------------------------------------
Last Update Date | 01/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2149 COLLINGWOOD BLVD
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43620-1652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-243-9178
-----------------------------------------------------
Fax | 419-243-4450
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 NAPOLEON RD APT K94
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43402-4644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-573-8415
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C.2607496-TRNE
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------