Individual
SHAKEYLA BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 PARK ST STE 101, COLUMBIA, SC 29201-2011
(803) 319-2558
Mailing address
2000 PARK ST STE 101, COLUMBIA, SC 29201-2011
(803) 319-2558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
20301
NC
101YP2500X
Professional Counselor
20301
NC
101YP2500X
Professional Counselor
Primary
8980
SC
Other
Enumeration date
06/23/2023
Last updated
06/26/2025
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