Bolin, Jeffrey Tyler
Bolin, Jeffrey Tyler is an sole proprietor health care provider with primary practice located at 2614 Charlestown Rd , New Albany IN 47150-2529. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Bolin, Jeffrey Tyler can be contacted via phone (930) 204-2414.Contact Information
Primary practice address
2614 Charlestown Rd
New Albany IN 47150-2529
Phone: (930) 204-2414
Fax: (765) 448-1864
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 163604 | Kentucky |
Profile Details
| NPI number | 1700279601 |
|---|---|
| LBN Legal business name | Bolin, Jeffrey Tyler |
| Credentials | MS, BCBA, LBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 17th, 2015 |
| Last updated | Oct 28th, 2022 - about 4 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 | 1700279601 | NPPES |
| Kentucky | Other | 1-15-18435 | BCBA CERTIFICATE |
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