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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 13 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 1407136567 NPPES
Wisconsin MEDICAID 42139300WI

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