IndividualActive
Bryan Bolwahnn, PHD, M.P.
NPI 1043247331 · Prescribing (Medical) Psychologist · Ball, LA
Provider details
- NPI number
- 1043247331
- Entity type
- Individual
- Primary specialty
- Prescribing (Medical) PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD, M.P.
- Sex
- Male
- Sole proprietor
- No
- License
- 926MPAP (LA)
Practice location
100 Gayven Dr
Ball, LA 71405-4903
Phone: (318) 641-0444
Fax: (318) 641-6118
Mailing address
100 Gayven Dr
Ball, LA 71405-4903
Registry dates
- Enumerated
- 2006-06-26
- Last updated
- 2013-10-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.