Individual
ASHLEY BOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N 22ND ST, RICHMOND, VA 23223-7020
(804) 644-9590
Mailing address
200 N 22ND ST, RICHMOND, VA 23223-7020
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1861604134
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945182
—
VA
Enumeration date
04/30/2009
Last updated
04/30/2009
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