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General NPI Number Information
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NPI Number | 1568132991
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Entity Type | Organization
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Legal Business Name | BOLER & ASSOCIATES, COUNSELING & CONSULTATION SERVICES, LLC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 126 ASHBY ST
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City | CALERA
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State | AL
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Zip | 35040-5628
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Country | US
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Telephone | 205-565-4469
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Fax | 205-637-4093
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Provider Business Mailing Address
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Address Line | 126 ASHBY ST
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City | CALERA
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State | AL
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Zip | 35040-5628
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Country | US
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Telephone | 205-565-4469
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Fax | 205-637-4093
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Authorized Official
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Title or Position | OWNER
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Name | MR. CORY DE'ANDRE BOLER
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Credential | ED.S, ALC, JSOCCP
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Telephone | 205-565-4469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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