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General NPI Number Information
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NPI Number | 1487808788
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Entity Type | Individual
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Provider Name | ANGELA HALL BOLES MS, NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 7490 HWY 87
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City | REIDSVILLE
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State | NC
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Zip | 27320-8815
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Country | US
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Telephone | 336-349-8848
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Fax |
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Provider Business Mailing Address
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Address Line | 798 W JACKSON ST
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City | MAYODAN
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State | NC
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Zip | 27027-2224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6726
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License Number State | NC
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