Bolivar, Mario

Bolivar, Mario is an sole proprietor health care provider with primary practice located at 112 Creekside Dr , Dallas GA 30157-7370. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bolivar, Mario can be contacted via phone (678) 237-1269.

Contact Information

Primary practice address
112 Creekside Dr Dallas GA 30157-7370
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1214 Oregon
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3071 Florida

Profile Details

NPI number 1639304934
LBN Legal business name Bolivar, Mario
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2009
Last updated May 15th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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