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General NPI Number Information
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NPI Number | 1881157089
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Entity Type | Individual
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Provider Name | DEBORAH L BOLGER LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2019
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Last Update Date | 04/13/2019
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Provider Practice Location Address
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Address Line | 14 RYE RIDGE PLZ STE 244
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City | RYE BROOK
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State | NY
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Zip | 10573-2858
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Country | US
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Telephone | 917-572-3288
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Fax |
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Provider Business Mailing Address
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Address Line | 14 RYE RIDGE PLZ STE 244
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City | RYE BROOK
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State | NY
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Zip | 10573-2858
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Country | US
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Telephone | 917-572-3288
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 009339
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License Number State | NY
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