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NPI Code Detail

MEDICARE: MS. CHRISTINA BOULDING LCSW

MEDICARE: MS. CHRISTINA BOULDING LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerSW6028FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K4526OTHERGROUP PROVIDER #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225149461
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINA BOULDING LCSW
Provider Business Mailing Address
First Line : 3633 HOLLOW TRAIL COURT
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684
Country : US
Telephone Number : 727-787-5236
Fax Number :
Provider Business Practice Location Address
First Line : 5707 N 22ND ST
Second Line : ACCESS CENTER
City : TAMPA
State : FL
Zip : 33610-4350
Country : US
Telephone Number : 813-272-2244
Fax Number : 813-272-3766
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 12/17/2012

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Directions to “ MS. CHRISTINA BOULDING LCSW” Practice Location

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