| Loretta L. Bolyard, Phd | |
|
125 W Granite St Suite 207 Butte MT 59701-9215 | |
| (406) 210-9801 | |
| (406) 723-5406 |
| Full Name | Loretta L. Bolyard, Phd |
|---|---|
| Speciality | Psychologist |
| Location | 125 W Granite St, Butte, Montana |
| Authorized Official Name and Position | Loretta Lynn Bolyard (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 4062109801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loretta L. Bolyard, Phd 125 W Granite St Suite 207 Butte MT 59701-9215 Ph: (406) 210-9801 | Loretta L. Bolyard, Phd 125 W Granite St Suite 207 Butte MT 59701-9215 Ph: (406) 210-9801 |
| NPI Number | 1508222837 |
|---|---|
| Provider Enumeration Date | 12/31/2015 |
| Last Update Date | 12/31/2015 |
| Medicare PECOS PAC ID | 5890097620 |
|---|---|
| Medicare Enrollment ID | O20160111000890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508222837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1479 (Montana) | Primary |
| Provider Name | Loretta L Bolyard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316284730 PECOS PAC ID: 2264686633 Enrollment ID: I20150929003218 |
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