Individual
MS. MARY HANSEN BOAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, NCACII, BSW
Contact information
Practice address
77 COUNTY RD 109, EVANSTON, WY 82930-2543
(307) 783-1088
(307) 783-1028
Mailing address
1013 CHEYENNE DRIVE, SUITE A, EVANSTON, WY 82930-2543
(307) 783-1088
(307) 783-1028
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAT-195
WY
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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