Provider Demographics
NPI:1215203286
Name:BOLTZ, DEBORAH ELAINE (M ED, MSCP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELAINE
Last Name:BOLTZ
Suffix:
Gender:F
Credentials:M ED, MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-021 LIKEKE PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2426
Mailing Address - Country:US
Mailing Address - Phone:808-239-2475
Mailing Address - Fax:808-239-7399
Practice Address - Street 1:45-021 LIKEKE PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2426
Practice Address - Country:US
Practice Address - Phone:808-239-2475
Practice Address - Fax:808-239-7399
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor