Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1360 | KS |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2005032299 | MO |
NPI | 1003914219 |
---|---|
Provider Name | Megan B Bolch |
First Address | Kansas City, MO 64108-4619 |
Second Address | Overland Park, KS 66211-2504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 28/08/2017 |