Individual
ERICA BOLEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
721 COMMERCE DR, WOODBURY, MN 55125-9118
(612) 767-7222
Mailing address
3195 MANITOU DR, WHITE BEAR LAKE, MN 55110-5600
(612) 767-7222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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