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Contact Information

BRYAN L BOLWAHNN, PHD, M.P.
100 GAYVEN DR
BALL, LA71405-4903
 Phone: 318-641-0444
 Fax: 318-641-6118
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRYAN L BOLWAHNN · (Male)

NPI Number 1043247331
Status Active
Credentials PHD, M.P.
Entity Individual
Enumeration date 06/26/2006
Last updated 10/09/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 926MPAP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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