Individual
KATELYN BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
206 LEVESQUE AVE E, WYNNE, AR 72396-2938
(870) 351-0312
Mailing address
10 COUNTY ROAD 367, WYNNE, AR 72396-8079
(703) 510-3128
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A1609114
AR
101YM0800X
Mental Health Counselor
Primary
P1904050
AR
Other
Enumeration date
09/15/2016
Last updated
10/21/2024
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