Individual
DENITA BOLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P-LCSW, QMHP
Contact information
Practice address
1801 N TRYON ST, CHARLOTTE, NC 28206-2704
(704) 685-6369
Mailing address
304 S VINE ST, GASTONIA, NC 28052-3560
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P004489
NC
Other
Enumeration date
08/13/2009
Last updated
08/14/2009
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