Individual
ANNA TAYLOR BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC, NCC
Contact information
Practice address
17115 KENTON DR STE 202A, CORNELIUS, NC 28031-5646
(919) 613-4594
Mailing address
11610 EASTWIND DR, CHARLOTTE, NC 28273-3687
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
15895
NC
Other
Enumeration date
11/28/2022
Last updated
05/30/2025
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