| Entity Name: | HOLLI L. BODNER, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Jan 1997 (28 years ago) |
| Document Number: | P97000000862 |
| FEI/EIN Number | 593421954 |
| Address: | 51 WALLACE AVE, SARASOTA, FL, 34237 |
| Mail Address: | 51 WALLACE AVE, SARASOTA, FL, 34237 |
| ZIP code: | 34237 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548422652 | 2008-06-30 | 2008-06-30 | 51 WALLACE AVE, SARASOTA, FL, 342376025, US | 51 WALLACE AVE, SARASOTA, FL, 342376025, US | |||||||||||||||||||
|
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| Phone | +1 941-351-8333 |
| Fax | 9413593148 |
Authorized person
| Name | HOLLI L BODNER |
| Role | OWNER |
| Phone | 9413518333 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY0004288 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BODNER HOLLI L | Agent | 7330 KENSINGTON COURT, BRADENTON, FL, 34201 |
| Name | Role | Address |
|---|---|---|
| BODNER HOLLI L | President | 7330 KENSINGTON COURT, BRADENTON, FL, 34201 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
