| Bolt Behavior Services | |
|
1747 Mandarin Estates Dr Jacksonville FL 32223-5549 | |
| (386) 846-8407 | |
| (904) 770-4882 |
| Full Name | Bolt Behavior Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1747 Mandarin Estates Dr, Jacksonville, Florida |
| Authorized Official Name and Position | Lori Ann Bolt (OWNER) |
| Authorized Official Contact | 3868468407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolt Behavior Services 1747 Mandarin Estates Dr Jacksonville FL 32223-5549 Ph: (386) 846-8407 | Bolt Behavior Services 1747 Mandarin Estates Dr Jacksonville FL 32223-5549 Ph: (386) 846-8407 |
| NPI Number | 1568909497 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 05/19/2025 |
| Certification Date | 05/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568909497 | NPI | - | NPPES |
| 106830500 | Medicaid | FL | |
| 017607800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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