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General NPI Number Information
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NPI Number | 1942254008
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Entity Type | Individual
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Provider Name | ROBERT M BOLLET ED.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 661 SEMINOLA BLVD
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City | CASSELBERRY
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State | FL
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Zip | 32707-3057
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Country | US
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Telephone | 407-678-6655
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Fax | 407-657-7211
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Provider Business Mailing Address
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Address Line | 100 LAMPLIGHTER RD
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2041
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Country | US
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Telephone | 407-657-6262
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY 3058
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License Number State | FL
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