Provider Demographics
NPI:1316022031
Name:BOLLON, NATALIE A (PCC-S)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:A
Last Name:BOLLON
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 MONROE ST NW
Mailing Address - Street 2:SUITE 27N
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-4160
Mailing Address - Country:US
Mailing Address - Phone:330-364-6488
Mailing Address - Fax:330-364-3307
Practice Address - Street 1:1260 MONROE ST NW
Practice Address - Street 2:SUITE 27N
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-4160
Practice Address - Country:US
Practice Address - Phone:330-364-6488
Practice Address - Fax:330-364-3307
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional