Provider Demographics
NPI:1972537603
Name:BOLAND, JANET UPDYKE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:UPDYKE
Last Name:BOLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HARBISON WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212
Mailing Address - Country:US
Mailing Address - Phone:803-781-4265
Mailing Address - Fax:803-781-7300
Practice Address - Street 1:1 HARBISON WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212
Practice Address - Country:US
Practice Address - Phone:803-781-4265
Practice Address - Fax:803-781-7300
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC423103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent