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Individual
JOHN DAVID BOYNE
Active
Individual
JOHN DAVID BOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA,LPC,SACIT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15064-130
WI
101YM0800X
Mental Health Counselor
3869-125
WI
Other
Enumeration date
05/01/2007
Last updated
11/30/2007
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