Bolz, Mary M
Bolz, Mary M is an individual health care provider with primary practice located at 220 Washington Ave , Oshkosh WI 54901-5030. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bolz, Mary M can be contacted via phone (920) 236-4700.Contact Information
Primary practice address
220 Washington Ave
Oshkosh WI 54901-5030
Phone: (920) 236-4700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 5045-120 | Wisconsin |
Profile Details
| NPI number | 1407136567 |
|---|---|
| LBN Legal business name | Bolz, Mary M |
| Credentials | B.S., C.S.W. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2011 |
| Last updated | Aug 22nd, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407136567 | NPPES |
| Wisconsin | MEDICAID | 42139300WI |
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