Bolt, Mary D

Bolt, Mary D is an individual health care provider with primary practice located at 310 N Clippert St Ste 4, Lansing MI 48912-4694. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Bolt, Mary D can be contacted via phone (517) 332-1691.

Contact Information

Primary practice address
310 N Clippert St Ste 4 Lansing MI 48912-4694
Phone: (517) 332-1691
Fax: (517) 324-0210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 1601000086 Michigan

Profile Details

NPI number 1922011097
LBN Legal business name Bolt, Mary D
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated May 27th, 2014 - about 12 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 1922011097 NPPES
Michigan MEDICAID 804679861
Michigan Other 540C312880
Michigan Other 640C326130

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