Provider Demographics
NPI:1063505584
Name:BOLINDER, CALVIN (PHD, PPCC)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:
Last Name:BOLINDER
Suffix:
Gender:F
Credentials:PHD, PPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 N NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6728
Mailing Address - Country:US
Mailing Address - Phone:505-437-8865
Mailing Address - Fax:505-437-1446
Practice Address - Street 1:1208 N NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6728
Practice Address - Country:US
Practice Address - Phone:505-437-8865
Practice Address - Fax:505-437-1446
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health