Individual provider · Type 1 NPI
Sandra Sue Dale Boulware, LPC, MAC
Professional Counselor · Miami, OK
NPI number
1235373465
Active
Practice location
1121 K St NW
Miami, OK 74354-2915
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | 440 (OK) |
| Professional Counselor | 101YP2500X | 15991 (OK) |
| Professional Counselor Primary | 101YP2500X | 440 (OK) |
| School Counselor | 101YS0200X | 109413 (OK) |
Professional Counselor: Definition to come...
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About NPI 1235373465
Sandra Sue Dale Boulware, LPC, MAC's National Provider Identifier is 1235373465, issued on May 1, 2009. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Miami, OK. The record was last updated on May 1, 2009.