Individual
DANIQUA TISHAWN BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
116 LEE ST, SHELBY, NC 28150-3839
(704) 487-4000
Mailing address
116 LEE ST, SHELBY, NC 28150-3839
(704) 487-4000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P017558
NC
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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