Bolyard, Katherine L

Bolyard, Katherine L is an individual health care provider with primary practice located at 911 N 18Th St Ste 1, Lafayette IN 47904-2288. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Bolyard, Katherine L can be contacted via phone (765) 447-7146.

Contact Information

Primary practice address
911 N 18Th St Ste 1 Lafayette IN 47904-2288
Phone: (765) 447-7146
Fax: (765) 447-4932
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 20041188A Indiana
Behavioral Health & Social Service Providers / Counseling 103TC1900X 20041188A Indiana
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X 20041188A Indiana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20041188A Indiana

Profile Details

NPI number 1689619215
LBN Legal business name Bolyard, Katherine L
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Dec 16th, 2019 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689619215 NPPES
Indiana MEDICAID 200186570A

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