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General NPI Number Information
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NPI Number | 1487958799
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Entity Type | Individual
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Provider Name | SARAH ROSE BOLOR
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Gender | Female
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Dates
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Enumeration Date | 12/29/2010
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 2980 S RAINBOW BLVD # 210D
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City | LAS VEGAS
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State | NV
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Zip | 89146-6531
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Country | US
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Telephone | 702-673-7462
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Fax |
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Provider Business Mailing Address
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Address Line | 6198 CARSON HILLS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89139-6871
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Country | US
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Telephone | 702-376-3693
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | IC-1214
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License Number State | NV
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