Individual
KATELYNN BROOKE BOLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 STANAFORD RD, BECKLEY, WV 25801-3143
(304) 252-6317
Mailing address
27 OSPREY RD, BECKLEY, WV 25801-1605
(304) 923-1013
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2354
WV
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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