Individual
VIRGINIA BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD, NBC-HWC
Contact information
Practice address
3628 LONGSTREET DR, PEARL, MS 39208-3814
(601) 481-5727
Mailing address
3628 LONGSTREET DR, PEARL, MS 39208-3814
(601) 481-5727
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1811
MS
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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