Male or Other

Kevin M. Boland PHD

Clinical Psychologist in La Crosse, WI(View on Map)

Full Name

Kevin M Boland PHD

NPI Number

1104820935

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/09/2005

Specialties

(Taxonomies)

Code

103TC0700X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

1127

Contact
Information

Purpose

Mailing
Location

Address

1836 SOUTH AVE
1836 SOUTH AVE

City

La Crosse
La Crosse

State

WI
WI

Postal Code

54601-5429
54601-5429

Country

US
US

Telephone Number

(608) 782-7300
(608) 782-7300

Identifiers

Identifier

39073400

Identifier State

WI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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