Brian Keith Boles, Wyoming LPC 1705
Counselor, Professional in Casper, WY. Individual provider (NPI-1).
NPI number1912376575
StatusActive
Last updated in NPPESJan 5, 2018
Details
- NPI
- 1912376575
- Entity type
- Individual (NPI-1)
- Name
- Mr. Brian Keith Boles
- Credential
- Wyoming LPC 1705
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2015
- Last updated
- Jan 5, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 1705 | WY | Yes |
Practice location
1430 Wilkins CirCasper, WY 82601-1336
Phone 307-237-9583 · Fax 307-265-7277
Mailing address
1430 Wilkins CirCasper, WY 82601-1336
Phone 307-237-9583 · Fax 307-265-7277
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