Provider Demographics
NPI:1306040514
Name:BOLINE, NEIL RICHARD (MSW)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:RICHARD
Last Name:BOLINE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 BROOK DR
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-8967
Mailing Address - Country:US
Mailing Address - Phone:816-532-0512
Mailing Address - Fax:816-532-0512
Practice Address - Street 1:2004 BROOK DR
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-8967
Practice Address - Country:US
Practice Address - Phone:816-532-0512
Practice Address - Fax:816-532-0512
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker