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Individual

JENNA MAE BOLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
1312 N MERIDIAN RD, KALISPELL, MT 59901-3095
(406) 260-8065
(406) 756-8546
Mailing address
1312 N MERIDIAN RD, KALISPELL, MT 59901-3095
(406) 756-6453

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-LIC-48617
MT

Other

Enumeration date
04/27/2021
Last updated
04/27/2021
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