NPI 1043247331

Bryan L Bolwahnn, PHDMP

Practitioner Prescribing (Medical) Psychologist Ball, LA

Practice location

Address: 100 Gayven Dr, Ball, LA 71405-4903
Phone: (318) 641-0444
Fax: (318) 641-6118

Registered specialties

Prescribing (Medical) Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TP0016X Licence 926MPAP (LA)

Other Psychologist providers in Louisiana →

Registry record

NPI: 1043247331
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Jun 2006
Record last updated: 9 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.