Individual
ROGER BOLEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASE MANAGER
Contact information
Practice address
238 SUMMAR DR, JACKSON, TN 38301-3906
(731) 935-8200
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 660-8759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/04/2007
Last updated
08/06/2009
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