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General NPI Number Information
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NPI Number | 1417100835
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Entity Type | Organization
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Legal Business Name | DAVID BOLTSON, PSY,D., P.A.
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1375 GATEWAY BLVD STE 31
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8304
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Country | US
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Telephone | 561-649-3309
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Fax | 561-570-5999
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Provider Business Mailing Address
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Address Line | 6300 HATTERAS CLUB DR
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City | LAKE WORTH
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State | FL
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Zip | 33463-6539
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Country | US
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Telephone | 561-718-9590
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Fax | 561-570-5999
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DAVID BOLTSON
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Credential | PSYD
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Telephone | 561-649-3309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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