Individual
MRS. ANDREA BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
7300 CARMEL EXECUTIVE PARK DR STE 115, CHARLOTTE, NC 28226-1310
(980) 243-3646
Mailing address
1811 SUMMIT VIEW PL, WAXHAW, NC 28173-7333
(980) 243-3646
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A17684
NC
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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