Search › Georgia › 1041C0700X
Mario Bolivar, LCSW
NPI 1639304934 · on the registry since 2009 · sole proprietor
Practice
- Address
- 112 Creekside Dr
Dallas, GA 30157 - Phone
- (678) 237-1269
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
- Licence states on file
- OR, FL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2009-05-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia