Bolling, Lanny Clarice

Bolling, Lanny Clarice is an individual health care provider with primary practice located at 101 Med Tech Pkwy Ste 200 , Johnson City TN 37604-4001. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bolling, Lanny Clarice can be contacted via phone (423) 232-6120.

Contact Information

Primary practice address
101 Med Tech Pkwy Ste 200 Johnson City TN 37604-4001
Phone: (423) 232-6120
Fax: (423) 232-6125
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X P2824 Tennessee

Profile Details

NPI number 1578696944
LBN Legal business name Bolling, Lanny Clarice
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Jul 20th, 2023 - about 3 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 1578696944 NPPES
Tennessee Other 103I681458 MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)

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