Provider Information for 1639407588
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Ms. BETINA LYNN BOLIN LCSW
Sex: Female
NPI: 1639407588
Last Updated: 2019-01-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1639407588 | ||||||||||||||||||||
| Enumeration Date | 2009-12-03 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 2707 BROWNS LN JONESBORO, AR 72401-7213 United States Phone: 870-972-4939 | Fax:870-972-4911 | ||||||||||||||||||||
| Primary Practice Address | 2707 BROWNS LN JONESBORO, AR 72401 United States Phone: 870-972-4939 | Fax:870-972-4911 | ||||||||||||||||||||
| Secondary Practice Address(es) | 212 S WALNUT ST 212 S WALNUT ST | ||||||||||||||||||||
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