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Individual
DR. TERESA ANN BOLES
Active
Individual
DR. TERESA ANN BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, PH.D.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6801069263
MI
1041C0700X
Clinical Social Worker
Primary
6801069263
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801069263
MSW
MI
Enumeration date
04/20/2007
Last updated
02/17/2023
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